Saturday, January 14, 2017

Sorry

I think its' s about time we did a collective sorry to our GP colleagues. I am tired, annoyed, angry and simply aghast at how many roads now end up at a GPs doorstep as the "reason".
I am a Consultant- and no one in my family is a GP- and I have no vested interest so lets be crystal clear- we really need to stand together as a community and more importantly, stand next to our GP colleagues. And to be honest, this is no political parties singular fault- we all are partly responsible for where we stand now. Those barbed comments about GPs, those ward chats about "GP, eh, as a specialty?", those "Huh, they deal wth coughs and colds"….at some point, it was inevitable it would cascade down to policymakers- and we have finally got there.

And I must admit, I have been in that brigade too- when does a joke stop being a joke? The last 6 years of my career has been eye-opening as regards learning what GPs do, recalibrating the understanding of the complexity they deal with- and if we as colleagues cant get past the thin layer of disdain we "specialists" do, then what chance politicians or others who don't deal with GPs day in, day out? I can actually sense the fight draining out of GPs, I hear good colleagues saying "I am done"…and this is not right. As a fellow clinician to another clinician, if it makes any difference to you, then as  Consultant, I will be categorical- there are many things we could all do better but the present NHS crisis is not down to GPs. And I am sorry it has come to this.

In 2010/2011, I ran the emergency stream in Portsmouth- and the target we achieved locally was 97.4%. Just 5 years ago. Since then we have poured resources into more and more staff, focussed relentlessly on emergency care- while the target has gone the other way- no lack of effort, no lack of process- while external after external folks have come around and tinkered with marginals- never stood up and tackled the one area which would make the biggest difference- social care funding. We have good managers, good clinicians- for whom the sole existence has become about sending someone home- or just knowing whether they can be outlied to some distant ward…we have to step back and think what exactly have we done to ourselves? This is NOT why I went to medical school- I don't want to know how many discharges I made in the 1st 2 hours of my ward round- I want to know whether the patient I discharged was safely done and didn't come back within 24-48 hours.

Process gurus may not agree with me- but frankly I don't care- because the only person in front of the family or indeed the GMC for a wrongful discharge will be me and my team- no one else. Whatever be the reason, whether it be families, structures, support, ageing population etc etc….this country needs more social care funding. Without that, this system is bust- to deny that is a bid to join the Trump administration to be perfectly honest

However possible, whether it be cross party agreement or whatever be the case, politicians of all colours, get your act together please.. the NHS boss, Simon Stevens- has come out and said so publicly- listen to what he is saying. And get social care funding sorted

In the meanwhile, to a GP colleague- wherever you are, a virtual hug, coffee or beer…for what its worth- thank you for all the work you do. 

2 comments:

  1. Thanks Partha for the comforting words and a virtual coffee
    All of us GPs have spent a number of yrs working in hospitals however not many hospital specialists spend any time in GP land and therefore the disdain for the unknown
    Sadly politicians are only interested in scapegoats today it's GPs tomorrow it might be specialist
    I think the real elephant in the system is indeed a fragmented and disinvested social care

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