Some of you may remember my quasi-rant of a fortnight ago, following Andrew Lansley’s eccentric proposals for the NHS. I argued then that to give the doctors even more of the funding was illogical – and that if he was looking for the entrepreneurial spark in good doctors, then he’d best not hold his breath. Those who wish to revisit the piece may care to look through the comment thread: not a single reader supports the Lansley approach.
Further, the anecdotal evidence from these and others who wrote to me personally suggests that it is the not very good but exceedingly greedy doctors who appear to have the entrepreneurial streak….up to but not including investment in patient care.
Anyway, since that initial post I’ve been having a little episode with my own local practice. I have to say it bears out everything I said in the original piece. Let me take you briefly through it.
I have a regular prescription which, under NHS rules, I must see a doctor about every six months if I wish to continue receiving it. (Even a diabetic taking insulin needs to do this, purely in order that his GP can check he hasn’t had a miracle remission).
I rang to talk to my doctor, because I was confident he wouldn’t ask me to make a 1200-mile round trip in order to confirm the need for it. It turns out my doctor has gone into management, God save us all. He’s been my GP for nine years. He went into management – a terrible waste, given his obvious skills – but nobody bothered to tell me, the client.
So eventually I tracked his pa down, told her the urgency, and asked if she’d forward an email onto my GP – as the only one familiar with my case. Well she said, he’ll be in here the back end of next week – would that be OK? No I answered, it wouldn’t. She gave me the email address and I sent it off twenty minutes later.
By the middle of that aforementioned next week, nothing had happened. Then I got an email from my GP to say hi, I hear you have a problem, can I help?
Eventually (following a further email) he renewed my prescription without hesitation – as I knew he would. And of course, had he been told earlier of the circumstances, he’d have done it right away. This is because he is a good and caring GP. However, he’s a manager now, so the world has lost another fine physician….and gained another naif who wants to play Cranleighs & Harvards. This is like us playing Doctors & Nurses when we were kids, except that we grew up.
Now I’d like to make a very simple point to Mr never-had-a-proper-job-in-his-life Lansley. I worked in a private-sector service industry for 35 years; and trust me, had I meted out ‘service’ like this, I’d have been fired within days.
The trouble with many primary care doctors is that in recent years, they’ve fallen in love with the idea of being in business….and successive idiot Health Ministers have encouraged them in pursuing this ridiculous idea. But the reality is that doctors are not competing for patients at all, because the ‘market’ (if we must persist in this antediluvian Thatcherite bollocks) is badly undersupplied. And the undersupply has not been helped by the lack of money to go round for ‘new’ entrants into this fantasy ‘market’ – most of which went to all those commercially sound doctors in the first place. These are the same oafs who took the Hewitt shilling – and invested it in themselves.
And now Mr Lansley has given them more money to muck around with.
Well like most other people, I don’t want primary care practitioners behaving as if they were entrepreneurs and management drones. The last entrepreneur in the GP community was Harold Shipman, and the legacy this go-getter left us with is still being gobbled up by the thousands of lawyers kept in work thanks to every death certificate arousing suspicion.
What does it take to get this through to a Tory Party still so oddly in thrall to the Mad Handbag one minute, and behaving like New Labour the next? I don’t want doctors calling themselves management, I want doctors who have a calling. I want proper, professional and dedicated GPs who work weekends and who come out at night when somebody’s ill because the ambulance service is stretched enough as it is. I’d like my doctor to turn up, not somebody who can’t speak English and is jet-lagged after a long flight.
In short, I want general practice back. Is that too much to ask?