I am now starting my second term representing South Yorkshire on the General Practitioners Committee of the British Medical Association. In my previous updates I hoped to give you insight into the form and function of the Committee that represents all General Practitioners in the United Kingdom. I have made myself available to you all through telephone, email and twitter. A number of you have taken me up on this offer and it has always been a pleasure of the role to try to help you where I can. I have previously explained to you that I see the role of the GPC regional Representative as an “expensive hobby” in that to pursue it you must be highly motivated and interested and must also expect to be out of pocket. With this in mind, I have not visited each LMC meeting in the region regularly over my term to reduce the temporal and financial burden of the role but regularly attend a joint South Yorkshire LMC meeting.
As your representative, I have certainly been no wallflower. I am a regular contributor to GPC meetings and online discussions and strongly assert the collective voice of South Yorkshire GPs as it is given to me by GPs and LMCs. Indeed, I sometimes do this at a loss to my own opinions being mindful of the fact that I was elected to represent you and not me.
Confidentiality – Helpful or Hindrance?
One of the limitations of GPC is that the conversation is often one way, in that I can speak on behalf of South Yorkshire, but very rarely am I able to speak on behalf of GPC. This is not for lack of want on my part but because of the limitations of confidentiality put on the Committee by the GPC executive. Whilst this is for good reason, it’s very frustrating. As I have tried to explain previously, usually only when there has been a press release am I able to tell you of the progress made by the GPC, by which time you have probably already seen it on the news or in the press. Consequently, instead of waiting for the BMA press machine to kick in I have taken to building a relationship with the media independently as a means on communicating with both constituents and patients about my own work in helping General Practice. For example, I have recently been on the Victoria Derbyshire programme representing our profession. I did ask for GPC support to fund my travel for this, but they declined – like I said, it’s an expensive hobby. I must also confess that despite this confidentiality I try to ensure the LMCs in our region are briefed on national occurrences well beyond what they are supposed to know at any given time.
Making South Yorkshire a Priority
It is clear that I have not languished in the role for the last three years but have used the opportunity to understand the assets we have at our disposal to make General Practice a better place for us all. I now have established relationships with local and national figures in the NHS, Politics and the Press. An example of this is a recent question asked by the Right Honourable Rosie Winterton during PM questions about the NHS which came about following a meeting between Rosie and I. This further resulted in dialogue between our region and the Right Honourable Jeremy Hunt on matters pertaining to the General Practice nationwide. Certainly, representing our region is a long game and takes time to establish an understanding of the system in which we operate as well as to gather the resources required to actually make a difference. Time spent with the wider committee at BMA House in London is only a very small part of this role.
The Role of GPC
This might be a pertinent moment to explain that I do not see GPC as the saviour of General Practitioners. Indeed, I think I am a well-known critic of GPC having often spoken of my belief that GPC is its own worst enemy. It has many limitations which hinder its progress in helping to further our speciality which I have detailed these in previous updates so I will not go into them again. However, what GPC does provide is access to some resources that help the plight of General Practitioners. Information, institutional and political connections and most importantly, status, which open doors to people you would not have otherwise had access to through other means. I am happy to live a quiet and unassuming life and do not crave accolade so please do not assume that I am narcissistic for recognising the importance of status, but when you need to get things done, status certainly helps.
The Importance of Being a GP, Not a Politician
I stood for GPC as a GP frustrated with the day job with the intention to deliver some stability back to General Practice – more specifically, to reduce the confusing annual changes to the GP contract. You may or may not have noticed that the changes to QoF over the last few years have been to minimise targets and not to add or alter new ones. Whilst I cannot claim credit for our annual negotiations I can claim credit for helping our executive to understand the need to minimise the impact of annual contract changes. On entering GPC it was the practice of the executive under Chaand Nagpaul to ask the Committee what they would like to see in the annual contract negotiations. My answer to this was “nothing new. GPs need stability.”. Thankfully it appears to remain the strategy of the executive to date and from time to time Chaand kindly remains me of my contribution to this ethos. It is my aim to further reduce tinkering at the edges of our contracts and aim to cease annual negotiations in favour of longer term negotiations and hence contractual stability.
Over my previous three year tenure on GPC, as well as acting as the South Yorkshire regional representative I have worked as part of the IT subcommittee and the Contracts subcommittee as well as contributing to work on the ethics of CCGs, the GPFV, care for the homeless and the Your GP Cares Campaign. I now understand the broach church that is medical politics, despite not actually wanting to be a medical politician and I try to avoid the fate of forgetting why I became a GP in the first place. My roots remain firmly as a jobbing GP in Doncaster suffering and enjoying the daily toil and success like you all. I remain affected by changes to our contract and bitterly feel the same distress as you when red tape is placed in the way of caring for patients.
The future of General Practice
We have some extraordinarily large challenges ahead. In particular, I think we are currently are fighting for the existence of General Practice as we know it. In some ways I hope you have not recognised that the NHS is being reorganised again, as I see a part of my role is to protect you from having to become involved in this. At the same to time you need to be aware that there are current changes ongoing in the design of the NHS that may be undoable. This is different from past reorganisations in that your previous primary care contracts held in perpetuity may be exchanged for time limited contracts which may be impossible to restore if you change your mind. This is a feature of the new Multidisciplinary Care Partnership, or MCP contract. We are also about to see the formal establishment of Accountable Care Organisations across the UK which will have a remit to oversee the commissioning and provision of care over large geographical footprints. Nobody really knows what these changes will mean for us or our patients as they are untried and untested in the NHS. What is clear, is that we need South Yorkshire to continue to have a strong voice and influence locally, regionally and nationally if we are to work in a health service that meets the needs of both patients and ourselves.
South Yorkshire does not need a career politician who will say yes to anything to get their name known.
Now is not the time to be a wallflower. Now is the time to be forthright and unerring.