I have the great advantage of visiting GPs in their surgeries almost every day of the week (and I am also married to one) and the stories I hear are remarkably similar: GPs having to work harder to stand still and getting rocks thrown at them for doing so.
Does the future look brighter? I’m not sure it does. Will BMA negotiators manage to steer the DH into a different direction where the interests of the GPs are protected? I don’t think so. And neither do most of my clients.
The great tragedy in this is something valuable, something that always worked well – general practice – is being lost as a consequence of the misguided mediocrity that pervades those that are supposed to value general practice.
So is that it? Is 24-hour retirement and escape from general practice the only option? I am, by nature, conservative (note small ‘c’ please), but if the 34,801 GP principals in the UK can find a way to act in concert, they may be able to make a difference.
Take the CQC requirements to update premises: I have a client with modern premises being told they need to spend £90,000 on upgrades to meet CQC requirements.
Not to worry, two-thirds will be funded through improvement grants. Oops – sorry the grants are no longer available. There is little evidence these improvements are likely to protect patients from an existing problem, but the threat is that failing to do the work will result in the premises being declared unfit for use. The practice might lose its contract, or not be paid the rent and rates reimbursement.
But what if all practices refused to do this kind of work? Would the CQC condemn all GP surgeries? Of course not. It would render the process unworkable. And rightly so.
Doctors’ one-day strike over pensions had little effect (wrong issue, wrong time), but the stakes are so much higher now. Negotiators on both sides need to know the end result of deadlocked negotiations is not an imposed DH solution; they might have to face GPs en masse refusing to play ball.
- Laurence Slavin is a partner with Ramsay Brown and Partners Chartered Accountants who specialise in the finances of GPs.