One disadvantage of our independent contractor status is that NHS managers have no direct responsibility for the hours GPs put in. It's no skin off their noses if we work 12-hour days; and there's no bonus for any PCT manager who minimises the administrative demands made upon us. Consequently we have to attend ineffectual meetings, must go on unnecessary courses and get bombarded with complex spreadsheets and directives. It all reduces the time available for patients.
Meanwhile NHS communication is abysmal, its IT systems remain non-integrated and GPs spend hours checking prescribing information which has to be transferred manually from hospital letters.
But what if PCTs were given the responsibility of enabling 'their' GPs to spend 80% of their time on patient-facing contacts? PCT managers who achieved this goal would receive a bonus (this objective would be for the PCT and its managers, not for GPs themselves).
Such a target would immediately force every PCT manager to think twice before emailing us, calling a meeting, inventing a new initiative or sending us a document of more than 10 lines. The reduction in time-wasting intrusions would be enormous.
So much for minimising interference: what about proactive assistance? Currently there is no incentive for NHS managers to help GPs become more productive, but with a target to hit, it would be well worth managers devising ways to streamline primary care administration through better liaison mechanisms, easier monitoring procedures for quality, innovation, productivity and prevention, and QOF, the centralised creation of IT reports for local enhanced services and simple, non-intrusive revalidation.
Just do the maths: reducing the time we spend on administration from 40 to 20% would hugely increase our capacity for clinical work - enough to absorb large quantities of secondary care activity, attain a better work-life balance and achieve a greater sense of job satisfaction.
And that's a target really worth achieving.