Friday, December 19, 2014

GPs...all up to you Part 3

Last blog was fun wasn't it...some high praise indeed from GP colleagues...a lot seemed to like it...but this will be the last in suggestions..because it's time to stop, time for those who do this job themselves a bit different..and for one last time? No, it's not more GPs.
Let's take time to look at an alternative universe...there is no more GPs around to fill posts, no locums, most have retired...what actually happens to the health system? Yes, we can scream and say it's all gone Pete Tong...but what would that force the system to do? What would happen if there were no more GPs? The system will have to look for alternatives..did I hear you say no one else can do what a GP does...yes, I agree...but needs must and in this alternative universe, they ergo GPs don't what now?

Well, one option is the NHS collapses simply due to the financial implication as it has been proven beyond argument that GPs are cost effective resources. So what now? We go insurance based? As a Consultant, that's not a bad option. Yes, it's rubbish for the population but we are in an alternate universe where we don't care about them, so hey presto, the Consultants or specialists are raking it in now. Let's be honest, if you have diabetes, and capacity to pay insurance, would you go see a GP or a diabetes specialist? Forget about cost effective medicine, evidence would want to see a specialist. Don't believe it? Look around the world...look at the systems are desperate including insurance companies to set up primary care...just to get some semblance of control. I know so as have been involved with organisations looking at setting up primary care in India etc....led by GP leaders from..hold your breath..the UK. Trying to show the way, ah the irony..don't you just love Pythonesque humour?

What else? How about this? Not enough GPs..struggling...hey how about I tot up all the hours used by the practice nurses to do diabetes care, give up the QoF points for diabetes and the local Trust runs diabetes for you? You don't have to see a single patient with diabetes ever. Did you say multi morbidity? Heck, most diabetes docs are general physicians too..we can do it all...just relinquish the money,..that ok? Palatable? Well, if you don't like last weeks suggestion, that's the alternative up again the Five Year Forward View. Think fast amigos..make your choice soon.Either take up the leadership or be led. Your shout. The cavalry of extra GPs may arrive a tad too late to rescue the show.

But we don't live in that alternative world, I actually would like the NHS to survive as a free at point of care system? Is that a personal wish? No...I am blessed enough to afford insurance and give me and my family the best treatment, the best specialists needed. Work wise, again, if GPs collapse, ah well, I go down the PACS model, employ more specialists, and boom, bobs your uncle, innit?  So what if all can't afford it, I am better what the heck? Right?
Well, no..wrong actually. Why? Because I have worked in systems which isn't free for all and it simply isn't fair. Health is a basic right for all, as is education and as lovely as it would be for me individually, I would love to think a little bit broader for me. The present system rewards me well enough, thank you very much.

So I am going to end this series by exhorting all GPs to spend even an hour a week by trying to convince even one undecided trainee to take up your chosen profession. Show them why you are proud. I get it ...the media have dissed you, I get it ...politicians don't like you..I get it all. I also know there's a huge collective of fantastic folks who are immensely proud of the work they do. Do whatever it takes to encourage people to join. See what is being published in Pulse..see what medial students are saying. Check the Deanery are losing the recruitment battle hand over fist. Say it loud, say it proud..its a good ,proud profession...heck if you want a specialist to do it for you, ask and I will help.

And you know why? Not because I feel sorry for GPs, not because I am trying to suck up to anyone...but because I am more keen on making sure the NHS survives. Because ladies and gentlemen, if you can't recruit and it collapses, I will be fine. Many, many other...simply put...won't.

I will stop throwing my tuppence in anymore..and I wish you all the best. It's a tough battle and certainly not an easy one to win. But if you ever need an ally, you know where to ask. It would be easier to say "not my circus"...the problem is it actually if you all collapse, you bring the whole house down with you.

Wishing you all a Merry Christmas x 

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