Speaking from the audience during a debate on the impact of CQC inspections on general practice at the RCGP annual conference 2018 on Thursday, GPC regional constituency representative and vice president of the European Union of General Practitioners (UEMO) Dr Mary McCarthy described the current method of inspection as ‘nonsense’.
She said: ‘They don’t [inspect in this way] in Europe. They are appalled at the way we do it. I talked to a Norwegian royal college of GPs who listened in silence and at the end put up their hands saying "if we did this in this country we wouldn’t have a GP left in five years" and I thought: "Yep, that’s kind of what’s happening over here too".
‘It’s because of this tick-box mentality that somehow you can judge competence and kindness and caring and compassion by ticking whether you have a bucket the right way up or whether your curtains are made of plastic rather than of material. This is nonsense,’ she added.
Dr McCarthy spoke following a debate between former RCGP Wales chair Dr Rebecca Payne and former RCGP Scotland chair Dr Miles Mack over the motion: ‘This house believes that CQC-type inspection is an essential lever in raising standards and ensuring patient safety.’
Speaking in favour of the motion, Dr Payne argued: ‘We know as doctors that if you don’t get the right diagnosis, how on earth can you provide the right treatment? The CQC-style inspections allow the right diagnosis, they allow [us] to pinpoint exactly where those problems are.
'Because clinicians like me can run around like headless chickens until the cows come home, but if you don’t have safe leadership structures nothing changes.
‘Getting that diagnosis right enables the right treatment, which is why I’m proud to work with CQC and I believe CQC-type inspections are essential levers in raising standards and ensuring patient safety.’
Addressing Dr McCarthy’s comments in her summing up, Dr Payne added: ‘European doctors and some parts of Europe practise very differently and in some cases to standards that we wouldn’t necessarily agree with. So yes, it’s different, but healthcare in those countries is different too.’
'Climate of fear'
Speaking against the motion, Dr Mack outlined how Scottish GPs were no longer living in a ‘climate of fear’ following the country’s move to using a GP cluster system of quality inspection after it abolished the QOF in 2016.
Scotland has a ‘new feeling of optimism’ since abolishing the QOF, Dr Mack said, adding: ‘Clusters are feeling they have the time and the data to make a difference in the care that they are providing. They are being encouraged to take on quality improvement (QI), to work on QI skills that they never had time or the inclination to do and it has made a profound difference to the way we are working.’
In his summing up, he said: ‘Mary is quite right to point out the international perspective. Norwegians appear to be completely amazed that we are all retiring way before 60. They think: "Why on earth would you do that? Do you not enjoy doing your job?".'
He said that the Danish response was similar, pointing out that the primary care system there had been 'to copy the Scottish model of quality clusters'.
An audience vote at the end of the debate showed the majority to be against the motion.