News from GP’s Conference
Addressing around 1500 GPs and health professionals at their annual conference in Liverpool, Dr. Clare Gerada, Chair, Royal College of General Practitioners, told their Conference that the profession is under pressure to
“replace the language of caring with the language of the market”
and that patients are not commodities to be bought and sold.
Echoing the concerns of many patients, she urged GPs never to lose sight of why they entered the profession – to care for the patient as a person.
“In this brave new cost-driven, competitive, managed-care world, I worry about the effect that the language of marketing is having on our clinical relationships. It’s changing the precious relationship between clinician and patient into a crudely costed financial procedure, turning our patients into aliquots of costed tariffs, and GPs into financial managers of care,” she says.
While welcoming the role of GPs in commissioning, Dr Gerada said that the commissioning agenda must not sacrifice long-term benefits for patients in favour of short-term savings.
“People often tell me that GPs make good commissioners because of the population-focus we bring to care. After all as a profession we see 300 million patients per year. If anyone can be said to have their finger on the pulse of the nation, surely it’s us. It’s an argument I’ve supported for decades. But we must tread carefully in this brave new world and do everything in our power to make sure it’s the public’s pulse we have our fingers on… not the public’s purse!”
Warning to doctors
Citing the HMO experience in America, she warns against doctors being doubly compromised between the best interests of patients and the need to save money.
“It’s the government’s job to decide how much we invest in healthcare – and what services the NHS should provide. Governments should have ultimate responsibility for decisions about rationing healthcare, not GPs.”
She concludes: “We all became doctors because we wanted to make a positive difference to people’s lives. It would be hard to devise a better and more inspiring way of achieving this than through the provision of excellent general practice care, within a universal health service. In times of austerity, we need to come together so that we can collaborate, cooperate and innovate… not compete against each other.
What matters to patients
“You expected me to talk about the Health Bill in England, but this Bill, like other reorganisations across the whole of the United Kingdom will come and go. Instead I have chosen to talk to you about what matters to our patients, now and for ever – a doctor who cares.
“I am convinced that there are enough of us to create a revolution in health care. Not a revolution that the Government is talking about in the Bill – in structures, payments and competition. But a revolution in values – one that will provide excellent care to our patients.”
She urged GPs never to lose sight of why they entered the profession – to care for the patient as a person.
But although she received a large standing ovation – there were those who weren’t so keen. One wonders if they were the doctors that welcome Lansleys reforms – and see the opportunities when it comes to commissioning contracts?
In his speech at the RCGP’s conference, Andrew Lansley said offering patients more choice did not amount to privatisation.
Announcing that monitoring of NHS healthcare is to be extended to 11 extra areas of medicine, the health secretary told the GPs in Liverpool that auditing would be extended to areas including HIV and breast cancer.
He said publishing better data would allow patients to make more informed choices and specialists to “compare themselves with the best”.
Lansley defended plans to give GPs more commissioning responsibility under the government’s NHS reforms, the government’s Health and Social Care Bill would encourage competition.
“For years, GPs have been telling me, ‘if only they would listen to us, we could do it so much better’,” he said.
“Well as I say, I am now ‘they’. I am listening to you. And I do want you to do it better.
But to patients already seeing waiting times going back to the bad old days, most don’t particularly want choice. What they want is to be able to go to a local hospital and not have to wait for an appointment. Nor do they want to be part of political claptrap excusing abdicating of responsibility. They just want to have their operations or tests done as quickly as possible, in infection-free centres.
Speaking to BBC News before Saturday’s conference, Mr Lansley said that offering more choice for patients did not mean privatisation.
“We’re not looking to turn the NHS into some kind of private industry, far from it.
“It’s a public service and it has to be integrated around the needs of patients.
“But there is a role, a big role, for patients in being able to exercise choice and therefore by extension where patients exercise choice, you have to have a choice amongst providers.”
Mr Lansley told the conference outcomes for patients in areas of medicine including breast cancer, prostate cancer and chronic obstructive pulmonary disease would be “audited, monitored and regularly published in the future”.
“From December we will pilot the publication of clinical audit data to detail the performance of clinical teams. This will then be rolled out across England from April next year,” he said.
“Better data means better quality in the NHS – for patients, for their specialist clinicians, and crucially for you – both as their GPs and as the future commissioners of those services,” he said.
Er – has anyone told Lansley that to get this data, someone is going to have to fill in more forms? Leaving even less time to deal with patients – the actual reason why the NHS exists.
He still hasn’t got the message, has he?