Time to stop GPs being the quick fix answer

Just because you are paranoid doesn't mean they are not out to get you.

GPs have certainly felt increasingly under attack from the government in the past few years, despite DoH assurances that no-one was out to get GPs in any way.

Now GP has seen a part of a government memo that suggests that the profession has not been suffering from some form of collective persecution delusion after all.

The document, released as part of a Freedom of Information request, is a letter from then chief secretary to the Treasury Des Browne to the then health secretary Patricia Hewitt.

In the letter, dated November 2005, Mr Browne states that he agrees with Ms Hewitt that the GMS contract should be tightened up. He continues: 'Furthermore, given the significant increases in GP profits over the past three years, the renegotiation also provides us with an opportunity to moderate the current financial pressures which the NHS is facing.'

The letter's content is consistent with the current government's attitude to general practice - that it offers a quick fix for any problem.

Need to reduce outpatient queues? Move more services into the community; in other words make GPs do it.

Need an attention-grabbing health policy? Invent a national vascular screening programme; it's alright, the GPs will do it.

Need to cut NHS spending? Oh well, there's always general practice.

Of course there was a bit of a problem: GPs were, and still are, some of the most trusted professionals in the eyes of the public. Plus a cut to general practice funding is in reality a cut in funding for the NHS services patients access most regularly. Service cuts are not traditionally a vote winner.

It is fairly easy to imagine how the thinking went.

To make these cuts palatable to the public, the DoH needed to distract people from any hint of a cut in NHS investment. So a scapegoat was needed and, lo, the image of the fat cat GP pocketing wodges of NHS cash on his or her way to a few rounds of golf was born (at least that's one interpretation you could place on events).

A simple stereotype that everyone can understand is a much more powerful tool in public opinion than an explanation of the technicalities of primary care funding, and so the DoH has been able to leap ahead in the PR war.

Now that we are beginning to see evidence of the government's attitude and that the BMA is launching its own PR campaign for GPs, it is time for the profession to create a few positive stereotypes of its own to counter those that are clearly out to get it.

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