New RCGP president Dr Terry Kemple wants the college to think outside the box

Dr Terry Kemple says becoming RCGP president makes him something like the 'monarch' of the college, while its chair is effectively prime minister. Chairwoman Dr Maureen Baker has executive, political power, while the president, elected for a two-year term, is a symbolic, ceremonial figure of influence.

Except, as Dr Kemple points out, he is the only college officer elected by the whole membership, giving him an important democratic mandate. Dr Kemple, speaking to GPonline at the college’s Euston Square offices, describes his influence as ‘soft power’.

Despite the role - which he took up on 20 November - being supposedly non-political, the Bristol GP has not shied away from policy issues.

During his campaign he said the college should tackle workload by using its authority ‘to declare what we can safely stop doing’; should find and spread the most efficient and effective ways to provide primary care services; and ensure medical schools are performance managed to recruit enough GPs.

The college has been working with NHS England, Health Education England and the BMA on a 10-point action plan to boost GP recruitment, retention and returners. But in his first interview since his election, Dr Kemple suggests that the very existence of a workforce crisis demonstrates that the college has been unable to exert the influence required to boost GP numbers.

GP recruitment

While the recruitment of trainees is not within the college’s power, Dr Kemple acknowledges, it should be able to influence medical schools that are failing to recruit people who want to be GPs. ‘[The college] can influence them,' he says. ‘It can raise awareness. The number of medical students and younger doctors choosing to go on to do general practice is too low. And perhaps this could have been foreseen a little bit better by the college.’

‘In any organisation,' he adds, ‘you have to be looking forward, thinking what are the trends, what's developing here. We are where we are, and we have to do something about it.’

As president, Dr Kemple says he will meet the heads of GP teaching at the medical schools to discuss how they can help redress the imbalance of students choosing general practice.

The problem as he sees it is that the schools do not recruit students on the basis of what specialism they want to join. ‘Perhaps there are people who want to be GPs that aren't being selected,' he suggests. ‘If we know we want 50% GPs, then shouldn't we be going out there recruiting people who want to be GPs, rather than neurosurgeons? You get the impression it's a very random process at the moment, how the medical schools choose people.’

RCGP priorities

Another idea for tackling the workforce crisis is to appoint RCGP-accredited appraisers. Dr Kemple, an appraiser himself, says he does not believe the quality assurance of the appraisal process is strong enough. There should, he suggests, be college-approved appraisers who can act as role models to GPs and help improve retention.

Dr Kemple, who chose to study medicine because his older brother suggested it was more fun than biochemistry, believes the college has become ‘a little bit disconnected’ from the membership. Part of his role will be to help reconnect the leadership with the members, he says. As the organisation has grown and become more ‘corporate’, he argues, many members may find it more difficult to identify the value of membership.

Building general practice

‘I would like the college to be the kind of organisation where if I didn't pay my subscription, within two or three weeks, I'd miss it. I'd miss the services it offers,' he says.

‘The problem is it's not like a gym membership,' he adds. ‘If you can't go to the gym this afternoon, you immediately feel it. If you don't pay your subscription and the college isn't doing its work, it's going to have an effect four or five years from now. So you have to believe in it to a certain extent. But as well as believing it, it has to be demonstrated to you: this is what you got for it. We're not building bridges or roads, but we are building better general practice.’

The college may not construct bridges and roads, but it did pay for the significant renovation of its impressive Euston Square offices before moving in 2012. Dr Kemple says he would have preferred not to move into the historic grade II* listed building.

‘I don't really believe in buildings,' he says. ‘The biggest strength of the organisation is the membership, and I think we could have had a building somewhere completely different, in the middle of the country so it's easily accessible.’

‘One of the things that disaffected members talk about is it being a London-centric organisation and having a building that they never get to use.’

He is ‘a bit sceptical’ about claims that being based in London increases the college’s influence. But, he adds, moving again now would be a ‘disaster’.

Thinking outside the box

The new president said during his campaign he wanted to challenge mindsets and 'groupthink'. ‘All the people in the college are intelligent people,' he tells GPonline. ‘But in meetings sometimes you need somebody with a slightly different mindset. And I've been blessed, I think, with a slightly different mindset. I'm really quite happy to challenge and ask questions.’

He insists his gentle criticisms of the recent direction of the college is not criticism of any past or current leaderships nor any particular policy decision. Rather, the corporatisation of the organisation, he believes, is a result of its growth and a reflection of similar changes in the health service.

All organisations, he argues, risk falling into groupthink. And wrong decisions and unintended consequences are just ‘the nature of life’. So people are needed who can challenge that, think outside the box, and raise questions.

‘I am very confident not accepting what somebody says and asking them why they said it,' he explains.

‘If everybody in the room thinks the same way, it means there are too many people in the room. So you have got to have people who think differently.’

The thread running through all of Dr Kemple’s comments is his desire to represent the ordinary college members who elected him.

He says he would like to see the college develop a membership experience for mid-career GPs. The college is already developing specific membership programmes for students, foundation doctors, first fives and fellowships. ‘I feel that although the college has been developing lots of other things, we have to develop the value of the college for mid and late career members,' he says.

Video: Dr Kemple sets out his priorities

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