Cameron reiterates promise of seven day access to GPs
BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5960 (Published 30 September 2014) Cite this as: BMJ 2014;349:g5960
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Would the provision of a skipping rope and sphygmomanometer to every household decrease NHS demand at a miniscule cost per person?
Competing interests: No competing interests
I am perhaps fortunate to have retired from the persistent battleground that is the National Health Service. While this is a misnomer in respect of General Practitioners - whom the populace as a whole mistakenly believe to be part of a nationalised organisation. We have claims from all political parties that they have the answer to provide universal access 24 hours a day to whatever service is up for criticism at the moment in time - all while "maintaining" the NHS budget (whatever that means in reality - does it include inflation? Does it include technological advance? Does it include medical training?
I am sure I am not the only practitioner who has worked in this publicly funded organisation who hits his head against a brick wall at party conference season.
It would be a brave but most likely successful political party which declared that "in the public good" it would not create policies on the NHS but would create a credible cross party committee working with appropriate professional and lay organisations to determine the funding, future and management of the National Health Service. After all it is health care, as distinct from education, taxation or benefit change, that is likely to affect every member of the voting population.
Perhaps one of the first outcomes of a sensible team approach to NHS management would be to nationalise GP services... many GPs are retiring and younger practitioners, as always, have a different view of a career in medicine. Many perhaps would prefer a portfolio of posts covering both secondary and primary service provision - the "independent contractor" status of GPs is an anomaly which restricts access to primary care and which limits career development. Taking the Bull by the Horns in the near future, perhaps paying-off the property owner independent contractors, would allow a road map for patient care to be implemented and managed effectively with a general rise in primary care standards. At the same time this would give medical practitioners more patient clinical contact time, more career flexibility, less risk of financial stress and a more structured lifestyle.
Let's be brave and think about newer ways of providing primary care.
Competing interests: No competing interests
Re: Cameron reiterates promise of seven day access to GPs
Yes I agree with Dr Nigel Higson. I think it's time the NHS was fully Nationalised, including a radical shake up of Primary Care. The NHS needs to become more public facing and responsive to the wishes of the public to access the service when they believe they need it. This is not a popular message for the profession, and will certainly need huge investment.
This is not a plan that could happen tomorrow, but would need to be planned for. GP recruitment will be critical. The negative image protrayed by the profession itself, does not help.
Critical to a new Primary Care is the removal of the independent contractor status. It will also need a recognition that Primary care is much more than just General Practice.
Since giving up my partnership to becoming a salaried doctor I have felt a huge weight lift from my shoulders. Now I see patients, do my collective duty and go home or do other things. Managers should manage, nurses should nurse and GPs should see patients that they can help without the burden of bean counting and box ticking.
I also believe that General Practice should be made more attractive to younger GPs by developing a career path, options to specialise (such as cardiology or ENT) that will help remove activity from secondary care. Flexibility in working hours is something else younger GPs want, so that they can also raise families, pursue other interests and generally have a life. They, rightly, are reluctant to commit to a partnership for life.
Politicians of all shades should grasp the nettle and go for a modern Primary Care, integrated with community services and local authority care provision.
Competing interests: Clinical Director of the CCG, leading the 8 to 8 and weelend availability pilot in Central Manchester and Primary Care champion for the Greater Manchester 'Healthier Together' programme of health service reform