Monday 12 July 2010

NHS White Paper

(For an article in Pulse Magazine)

Just read the NHS white paper and it looks like we GPs can finally stop being back seat drivers of the NHS and have a go at the wheel. Well I say we, I really mean GP Partners. Salaried GPs will still be trying to fill the whole left by the GP Partners who have gone on to become new NHS managers, play golf or sit in the staff room with their feet up. Locum GPs like me will fill the whole left by all the burnt out salaried GPs who can’t take it anymore, and the gaps left in the rota by GP Partners playing golf.

Of course I am being my usual cynical self, its not all bad. I am sure great good can be achieved over time but the level of re-organisation required for the NHS mark II (as I like to call it) is quite terrifying. It won’t be cheap so how we can save £20 billion and reorganise the NHS simultaneously is anyone’s guess. I’m hopeful that GP Partner numbers will increase fairly dramatically as I don’t think salaried GPs will want to get hands dirty without a hefty pay rise.


I’ve heard other GPs talk about it being a bit like fund-holding all over again, but this it is compulsory. All GP practices will be forced to be part of a GP consortium. There they will have to fight it out, argue, arm-wrestle or do whatever GPs are going to do to decide where the money goes to. No longer can you fob off your patients and say the PCT has pulled the funding for tummy tucks, it will all be your fault. Now when you see a patient needing an operation you’ll be thinking how much this is going to cost and how much abuse will I get at the next GP consortium meeting for referring them.


Patients are meant to have control over their medical records and can go to whomever they want, wherever they want for an opinion. Practice boundaries are to be abolished - its nice to see the government listened carefully to all the objections to this problem, then ignored them, screwed up the bit of paper it was written on and then burnt it.


You’ll be over-joyed to hear patients will have choice, choice and a bit more choice with added choice on the sides and sprinkled on top. Apparently patients like to choose. It doesn’t matter that all that choice is expensive, unnecessary and a bureaucratic nightmare. Almost always when I’ve asked patients about where they would like to go to its wherever is nearest. Regardless of the fact that the nearest place doubles as a butchers shop at the weekend and offers a 2 for 1 special on MRSA and C.dif infections

Of course there will be some GPs who will be positively tumescent at getting their hands on a big pot of cash to play with. I wonder how quickly their tumescence will shrivel when they realise they’ll get the blame if it all goes breasts skyward.


However, GPs are well known for agreeing on everything, their lack of financial motivation and running multi-billion pound budgets. I honestly can’t see anything that could go wrong.