Editorial: DoH mandarins must stop demonising GPs

Somewhere in the bowels of Richmond House is a room with flashing lights and hypnotic devices where ministers and officials are brainwashed in the style of Frank Sinatra in The Manchurian Candidate. But rather than 'East is west, etc' the mantra for mandarins is clearly 'PCTs good, GPs bad' given that they are sticking to that line regardless of the evidence.

Recently we have heard from acting head of the NHS Ian Carruthers that the high quality scores showed how PCTs were caring for patients with cardiovascular disease. Now health minister Lord Warner has completed his course of treatments and is accusing GPs of falsifying access figures. He plans to introduce random access checks of surgeries to solve the 'mystery of the real difference between what patients and practices report on access'.

Brainwashing is the only possible explanation for how the minister with responsibility for primary care can have so little knowledge and understanding of an issue which is apparently central to the government's plans for this part of the NHS.

First, until now practices have had nothing to gain from artificially boosting access figures. The benefit accrued to PCTs striving for the highest possible star-rating.

GPs were the first to report incidents of PCT gaming, such as warning practices when access checks would be made and offering extra locum cover for those days to ensure appointments were available.

As for patients and practices reporting different findings on access, Lord Warner should by now understand that two different things are being measured. In recent years practices have been measured on the availability of an appointment with any GP within 48 hours. Patients regard access as being able to book an appointment with a GP of their choice at a convenient time and day. Again, GPs have been very clear about how 48-hour targets merely serve to disincentivise practices from offering advance appointments. Now the DoH is taking up this cause as if it was its idea all along and GPs have been trying not to see patients.

Sadly, facts don't make good headlines and having cast GPs as the villains of the piece in recent months the DoH has found some convenient scapegoats.

Over the past few weeks, this column has called on LMC representatives to give Lord Warner a fair hearing and talked about the need for GPs to bring positive solutions to the negotiating table with the DoH rather than blank refusal of change.

Such a process must be two way. Those in the Richmond House machine and their representatives must also treat the profession fairly and work with the facts, not some form of demonising mythology. Only then can reform move forward.

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