Involve family doctors in planning primary care, says GP's leader, UK

Main Category: Public Health
Also Included In: Primary Care / General Practice
Article Date: 16 Jun 2005 - 10:00 PDT

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With a government white paper promised on family health services, the leader of the UK's 43,000 GPs today (Thursday 16 June 2005) called on the new Secretary of State for Health to listen to family doctors, involve them, and trust them when drawing up new plans for primary care.

Dr Hamish Meldrum, chairman of the BMA's GPs committee, in his keynote speech to the annual family doctors conference*, London, criticised government health initiatives that appear to work at cross purposes. He described the challenges facing general practice including the government's "infatuation with private sector involvement in the health service". The NHS was all about patients, and patients trusted family doctors, "so why don't politicians trust us?" he asked the conference which represents GPs everywhere in the UK.

His message to Patricia Hewitt, the new Secretary of State for Health was : "Involve us; listen to us; trust us. You will not find us wanting. I will not criticise you for not always acting upon what we say, but I will criticise you for not involving us or listening to what we have to say."

Describing the government's "headlong rush to create more private sector provision of NHS care", Dr Meldrum said: "I don't believe we should oppose private sector involvement, per se, but before we go too far down that road let's just ask a few questions. What are the problems to which private sector provision is the answer? Will it really improve capacity in the NHS? Will it make the NHS more efficient? Will it solve the workforce problems in the NHS? Is it value for money? Will it provide better services for patients? Where is the evidence? Even more particularly, where is the evidence that it will improve rather than destabilise our present system of general practice?

"Proponents of private sector provision state that it will do several things. They say it will innovate, create diversity, be more flexible and adaptable, be more efficient." British general practice had been one of the most innovative and forward thinking parts of the NHS, he said. It was incredibly diverse, and had demonstrated flexibility and adaptability.

"Given that we carry out almost nine-tenths of the consultations in the NHS for just over one-tenth of the resources, that we do this with fewer doctors per head of population than many of our western neighbours, I don't believe that we're the ones who need to demonstrate our efficiency compared to other methods of primary care delivery," he said.

"I don't think we should be afraid of the principle of private sector involvement. I have confidence in the ability of UK general practice to compete. But there is one big proviso. We must be allowed to compete on a level playing field and not with one or both hands tied behind our back….we have to ask, if private sector provision is so wonderful, so efficient, so effective, why does it have to be given such a significant financial leg up?"

General practice was not without its problems - there was still a shortage of GPs, contract problems, underfunding of GP trainers and training, a failure to sort out community hospitals and "the persecution of small practices" said Dr Meldrum. He urged GPs to follow the theme of their conference and speak out for general practice and the value of their core principles.

PCT NAMED AND SHAMED

The high scores achieved on the new contract's Quality and Outcomes Framework (QOF) had been a major success, said Dr Meldrum.

"Given this, it is a disgrace that some PCTs have been making crude and arbitrary distinctions between practices as a consequence of their relative performances in the QOF. A Primary Care Trust in the midlands is a case in point and its name and shame attitude, hectoring tone and implied threats in respect of several of their practices is completely unacceptable. Well, naming and shaming can work both ways and I believe that the Heart of Birmingham PCT's behaviour cannot and should not be tolerated."

The high QOF achievements demonstrated that the quality of UK general practice was second to none, he said, adding : "We must build on the success of the QOF and what I believe to be the highly cost-effective move towards helping, at long last, to provide a genuine HEALTH service rather than just an ILLNESS service."

The full text of the chairman's speech can be found on the BMA website at:
bma.org.uk/ap.nsf/Content/LMCConf2005Meldrum

The agenda can be found at:
bma.org.uk/ap.nsf/Content/LMCConf05Agenda

* The Local Medical Committees (LMCs) Conference 2005 is taking place today and tomorrow , Thursday/Friday 16-17 June, at the Institute of Education, Bedford Way, London. WC1H 0AL. The theme is "Speaking out for general practice".

http://www.bma.org.uk

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