You will not have seen my blog for several month, I had one or two (or ten) comments from clients that my thoughts were unduly negative. They were, and by the looks of things they were right to be. But I am going to return to my blog, and add a twist.
Yes, general practice is struggling, and I think it is at a lowest point I can remember – so just maybe, things can only get better (thank you Professor Brian Cox). In other words, the pendulum must swing back. It did in 2004 and it needs to again in 2016.
So what have I been doing to help this happen? I emailed my MP whose name I shall spare at the moment, a Conservative back-bencher. I explained that on his government’s watch, general practice is being damaged. I detailed my concerns about recruitment, succession and funding and the mistaken belief that bigger is best (it isn’t, it is just different – more about that in another blog).
I received a reply in days – a long and eloquent response all about the junior doctors' strike. He had not even read my email – just seen the header (problem in the NHS or something). So I complained and asked for a response. Nothing. I emailed again... nothing.
Finally, I bundled copies of all the papers and sent them to him at the Palace or Westminster. I got an immediate apology, and an assurance he would take this up with the Secretary of State for Health. Lo and behold, a few days later I get a letter from a junior minister assuring me that all is well, there will be thousands of more GPs by 2020, funding has never been better. Did they really move Richmond House from Whitehall to Disneyland?
I ended this depressing process by informing my MP that he was now on notice that general practice is being damaged on his watch and that being so informed he has a responsibility to do his bit. I am holding my breath.
Some weeks ago now, I gave a talk to the lay directors of eight CCGs, ostensibly to help them with the CCG's PMS reviews. This was a two-hr talk explaining how general practice works.
Using our own data I demonstrated that our average PMS practice receives £14 per patient more in funding that GMS. I also demonstrated that our average PMS practice earns just £4 more in profits per patient that GMS.
So if you are going to cut the £14 from the income, the same practice will have to cut £10 per patient from their costs to remain equal with GMS. What will end up getting cut is the PMS practice’s salaried GPs, so be advised NHS England, these cuts will affect access and don’t be so naïve to think that such cuts can be made in a short period of time without destabilising the practice. They understood, were surprised and not unsympathetic
So come on our masters, release the pendulum before it is too late.
- Laurence Slavin is a partner with Ramsay Brown and Partners Chartered Accountants who specialise in the finances of GPs.