Dr Kailash Chand: Let's unite to save general practice

The NHS is celebrating its 67th anniversary, but now faces one of the most difficult periods in its history.

Government policy and privatisation mean the NHS as we know it will be gone in as little as five years.
The way the NHS is being managed by health secretary Jeremy Hunt and the government is a stunning example of how not to do things. The roadmap of its policies is leading to the complete privatisation of the NHS, a process that has deep roots in Thatcherite ideology.

The new NHS Act has not just repealed society’s contract with the health service, it has made the NHS a repository of privateers with the mindset of venture capitalists. I believe it will be a completely different system in five years – much worse in terms of access, equity, health outcomes and cost.

We are inexorably moving towards a system ruled by bogus choice, competition, market forces and diversity of suppliers. By opening every NHS corner to any qualified provider, the whole service can be taken over by private companies, with a few token charities and mutuals. NHS hospitals, facing the consequences of cherry-picking by private consortia, risk bankruptcy when left to deal only with complex cases.

By the next election, the general practice model of the past 67 years will see revolutionary changes.
We might begin to see GPs working as part of a broader non-acute sector, in larger teams, in
different settings and for new employers.

A new tier of physician associate is planned, and more nurses and pharmacists. These skilled
professionals could be allowed to take on the bulk of work traditionally associated with GPs. All of this would be unrecognisable to our GP from 1948.

We now need to pledge to unite as a profession to save the NHS and general practice. The NHS’s greatest strength has been the employees, who have shown resilience at difficult times, innovated to find new cures and treatments, and provided quality care as their professional code demands.

It is not too late to limit the damage of the past three years, but politicians need to listen and staff need to be empowered to do what they do best.

  • Dr Chand is BMA deputy chairman and is writing in a personal capacity

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