She fixes their gaze and tells them that only a Supreme Being can create matter out of nothing.
I am having more and more conversations with GP practices along similar lines, the issue being how do you provide a service without the resources, or to be more specific how to reconcile having to provide a second rate service because the 'business' side of general practice does not justify the level of service that the GPs have happily provided in the past.
Last week, I met up with a two partner PMS practice. Their profits have fallen from £100,000 per partner to £40,000 per partner as a result of cuts in their budget. The continued cuts will mean that next year the profits will fall to around £25,000 per partner. This practice is in a deprived part of London and they employ far more GPs than you would usually expect for their list size. They claim this is necessary to meet patient demand, the PCT claim they are overfunded.
So how do you square this? The practice cannot carry on like this, and so one of the GPs will have to be made redundant. The partners are uncomfortable with this, they have spent the last 10 years running a respected and excellent service but without the resources, it just can’t be done.
On a similar vein, later this week I have been invited to attend a meeting with a practice, their PCT and their MP to plead their case regarding their loss of funding.
I mentioned this practice in a recent blog, they too have had their funding cut and their profits are expected to drop to around £60,000 per partner. The only way this practice will be able to continue is to reduce their costs but in the world of general practice, a reduction in costs will have an effect on service.
GPs tend to run their practices efficiently, and the idea that GPs can make efficiency savings in the same way that a PCT can without a corresponding effect on service is mistaken.
In many cases, a reduction in funding means that the partners work harder to achieve the same level of service for their patients, the business side of the practice may look healthy, but there is a cost to the partners in terms of fatigue.
So to return to the issue, if the funding to provide a first class service is not made available, and the GPs themselves cannot meet that shortfall in terms of increased workload, who should bear the responsibility?