Liam Farrell: The little GPs with our fingers in the dyke

It's deja-vu all over again; what goes around comes around, and only the names have changed.

Twenty years ago, the Tories called it GP fundholding, now they call it GP consortia, which they obviously think sounds a bit posher, but is actually more like Frankie Howerd's slave girl in Up Pompeii!

It's not that I have anything against GPs being involved in management of the NHS; however unenthusiastic and poorly-trained at management we are, we can't be any worse than the kind of incompetent bureaucrats that seem to be drawn to the health service like dingy moths to a flame.

The NHS is full to the brim with managers whose only skill is to talk the talk and who use this skill to conceal their incompetence and their inability to actually get anything done, and to come up with terms like GP consortia.

Different ideology, same old garbage, it blithely transcends party political lines. New Labour weren't any different; health trajectories and foundation hospitals, anyone? The bureaucrats don't care about patients, all they care about is protecting their own little private empires, and they will take responsibility for nothing because they live in a perpetual funk about getting the blame.

And, in contrast, taking responsibility is something that GPs are good at; we aren't afraid of it, we do it every day, we make the call, we don't pass the buck, sending home kids with URTIs and adults with minimal chest pain, knowing that there is a small but definite risk that it could turn out to be a disaster, that the kid could turn out to have early meningitis and the adult an infarct, and if our educated guess is wrong we'll be toast. Managing this uncertainty is a grave responsibility and an onerous task but it's one we GPs do supremely well, with the absolute minimum of fuss, and it's a skill that the NHS could not function without.

Because we know we can't admit them all, as the hospitals would drown in a sea of inappropriate and expensive investigations and treatments; our ancient profession is a high and noble calling, courage and steadfastness is our creed, we stand on guard though the darkest watches of the night, we are The Thin Red Line.

Or call us something else; The Little GPs With Our Fingers In The Dyke.


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