Category Archives: Media Response

“It’s not our fault, those nasty GPs made us do it!”

“Morning, how are you? So you’re struggling with your knee? Ok, let’s take a look, pop up on the couch.

Right, what I suggest for the time being is some anti-inflammatories and gentle exercise. It’s better to avoid those drill wielding hospital doctors for as long as possible. It’s a bit of a slippery slope once you embark on the surgical route. Let’s see if time and patience will do the trick.

Hello again, no better? Physiotherapy for you then I think. They can work wonders.

Still no better? Righto, let’s get an X-ray sorted and we’ll get you off to the orthopaedic guys, to see if they can help. There are a number of possibilities and treatment options depending on X-ray and scan results, let’s see what they say.”

So, this is option one. This is what goes on in every GP surgery, every week of the year, but let’s take a look at the parallel universe of the British Orthopaedic Association.

“Morning, how are you? So you’re struggling with your knee? Ok, let’s get an MRI and ask the orthopaedic surgeons to see you.

REALLY??? Are you serious?

General Practice and Practitioners are becoming inured to the constant barrage of abuse and approbation from politicians and the media, but there is a particularly offensive sting to ill-considered criticism from colleagues, who frankly should know better than to throw stones in their secondary care glasshouses.

The phrase, “…….if GPs are doing their job properly….” has a wonderfully arrogant and patronising ring to it don’t you think? And as for, “………performance of this investigation (MRI) replaces the traditional medical skills of history taking and physical examination of the patient…”, well frankly, words fail me.

General Practice effectively manages the vast proportion of clinical presentations without the need to refer to secondary care. Those that are referred are done because further management is beyond the clinical expertise of the referrer, hence transition to the supposed ‘specialist’.

But it appears not. Orthopaedic surgeons are apparently incapable of utilising “the traditional medical skills of history taking and physical examination of the patient”. Nor are they able to deal effectively with patient expectation. No, instead it appears it’s the GPs fault for not managing the patients properly in the first place.

If we listen carefully outside the orthopaedic clinics, we will hear the bleating cries of the poor little lambs, “we didn’t want to do an arthroscopy, those nasty GPs made us do it.”

The Cat is Out of the Bag

Well the cat is really out of the bag this week; not one, but two ‘elephants in the room’ that many of our leaders are just too afraid to address.

Cat walks out of the bag

First of all we had Zoe Norris incensed by yet more “useless, fat cat GP” rhetoric, and then in the wake of the “Christmas 4 day break” A&E/OOH apocalypse, we had a superb blog by Prit Buttar on the access/demand issue.

What still amazes me, especially given the Twitterfest that ensued, is why addressing demand is seen by some as being so recalcitrant.

Appropriate use of resource is now part of our everyday life; we are encouraged to recycle at every turn, we are exhorted to reduce our carbon emissions, protect our rain forests and limit our consumption of fossil fuels. We have publicity campaigns to ‘switch it off’ for electricity, and ‘turn it off’ for water. The police judiciously remind us that unless we use their services wisely, they will not be free to respond when we really do need them. So why is healthcare so different?

“Free at the point of access” is the tenet of the NHS, but of course it isn’t really free; like any other commodity, it is paid for one way or another; unless people are prepared for more public money to be put into the NHS pot, we have to learn to use the budget wisely. There is no ‘magic porridge pot’ of health provision, somehow we’ve got to work with what we’ve got.

To our detractors, on the subject of GP pay, I say this. Any system that provides 90% of the activity for 9% of the budget is good value. Forget about individual pay, General Practice is a slick business system that represents huge value for money for the UK taxpayer. To those that complain about the fact that we are better paid than most of our European colleagues, I say, do you understand the complexities of the Primary Care role in the UK compared to that on the continent, where people only go to see a GP if they have a ‘simple’ self-limiting illness?

To those that complain that access is not adequate and that we should be open all day, all evening, 7 days a week, I say ok, so how are you going to pay for it? Unless the GP budget is doubled, we can’t provide the same service 24/7. And if the appointment isn’t available for you to access for your cancer diagnosis or if Granny is left waiting for 12 hours, struggling to breathe because the system is buckling under the weight of demand from people who have forgotten to order their oral contraceptive along with the Christmas Turkey are you going to be happy with that?

I actually embrace patient involvement in service provision. Believe it or not, it’s easier for me to say “Ok, you choose. Do you want cereal or toast, you can’t have both?”

For anyone that knows me, or has read my blogs, you will know that I am an upbeat, happy soul. Crazy though it seems, I really did go into medicine to help people rather than make money though I could have quite easily chosen a more lucrative career.
Stranger still, despite the constant barrage from the politicians and the media, I still enjoy my job. There I’ve said it, I still like being a doctor and helping my patients. Unfortunately, a lot of my colleagues are not so blessed with naturally high serotonin levels and are emigrating or retiring in droves and I cannot tell you how many are simply looking for a different career path.

A welcome and timely article was printed in The Sunday Times only this morning, by Professor Angus Wallace, on the looming crisis.

The trouble is, this isn’t what we signed up to. Across the land, in GP surgeries and hospitals, Doctors are collapsing under the weight of criticism & burgeoning workload. This isn’t a General Practice crisis, this is an NHS crisis.

We’ve tried to ration the services, to spread the jam as thinly as possible, to try to keep the system afloat but, now it’s time for patients to take some responsibility for their NHS and learn to use it wisely & considerately, before it’s too late.

A Deafening Silence Waiting to be Broken

I read with disappointment the downright malicious article written in the Daily Mail by J Meirion Thomas.

In many ways it reminds me of something we are more used to Nick Griffin spouting than an esteemed and highly educated colleague (it is interesting that NG came out on twitter to defend JMT – who needs enemies when you have friends like him!).

I sat down to write some cathartic reparté on behalf of my entire GP fraternity when I realised that mine is not the voice we should all be hearing.

This, therefore, is a challenge to all the ‘Powers That Be’ to do the right thing and publicly sanction JMT. Their inaction would be yet another example of their indifference to the public denigration of our hard work and very existence that appears in the media on a daily basis.

To the GMC……

JMT is clearly in breach of the ‘Duties of a Doctor’. This article is a brazen challenge to your authority and (in) ability to act. The GMC receives the bulk of its funding via GPs (40000 GPs paying £400 per year) and is duty bound to not just put out a statement condemning JMT but owes it to its members to act in a show of strength and support. Do your job.

RCS and RCGP……

I don’t know how these two organisations would choose to respond to such hate. However, the RCS should be feeling very, very uncomfortable about their colleague essentially upsetting every doctor in the UK who is female, non UK in origin and now also GPs. Anything other than condemnation in the strongest strength fundamentally undermines the ‘linear integrated primary / secondary care’ approach the next five years is meant to bring. Dr Maureen Baker – this is your MTAS moment, a failure to act will set college relationships back a decade.

Mr Hunt……

I laugh at him even bothering to comment. However, his views would be facinating!!!

The NHS trust and the Private Hospitals (x 3) that he works at…….

Your patients all come via their GP. You rely on positive working relationships with all of these individuals to provide the level of care that we all aspire to. It is the community teams we lead that gets a patient home and appropriately supported, to try and avoid bed blocking, our admission avoidance efforts that stops you breaching all of your targets. Is this mouthpiece someone you want to be representating your organisation? A lack of response would suggest you think he is, or you just don’t care.

The BMA/Londonwide LMC….. I would suggest you send copies of this and JMTs other article in the Daily Mail about Female Doctors to every one of your member practices, stand back and wait to see what happens.

Ben Davies