Gerada reflects on 'exhausting' first year as RCGP chairwoman

It's been an 'exhausting' year for Dr Clare Gerada, who could not have chosen a more tumultuous time to become chairwoman of the RCGP.

Dr Gerada: ‘I hate seeing negative comments but I want to tackle them and address them’ (Photograph: A Deverill)
Dr Gerada: ‘I hate seeing negative comments but I want to tackle them and address them’ (Photograph: A Deverill)

But since taking up the chains of office in November 2010, her campaigning leadership style has made her one of the most popular figures in general practice.

'I have had unbelievable support from the members,' she says. 'I am humbled by the support I've received.

'It's been a difficult year and in my darkest moments they have given me strength. But equally I know they will tell me if I'm getting things wrong.'

Forums and Twitter
Dr Gerada is certainly not one to shy away from criticism or a challenge. She is renowned for her participation in online forums and on the micro-blogging website Twitter.

'I'm not afraid to go into the blogosphere every day to see what's being said about me, the NHS and the college,' she says.

'I hate seeing negative comments but I want to tackle them and address them and apologise if necessary. I think it's important that people see me warts-and-all.'

It's this down-to-earth approach that has earned her admiration from GP colleagues.

'I am a grassroots GP and I hope people believe that. I still do two days a week of clinical work and will be adding another session in April.'

Her practice background in central London is not orthodox - a small number of partners running several practices with salaried GPs - but Dr Gerada believes she has a better view of the NHS reforms as a result.

'Because we have entered the market, in inverted commas, and compete to take on practices, I understand the tensions and the risks that are facing the profession. Hopefully our practice has managed to retain its NHS values.'

She has also chaired three GP commissioning groups and was a policy adviser to the DoH for eight years. This experience enabled her to hit the ground running when taking over as chairwoman just as the battle over the reforms began.

'The DoH does not faze me because I worked there and had a very good insight into the way it works. A lot of the previous chairmen have been academics or educationalists, whereas I am a GP partner with a policy background.'

She believes the Health Bill's biggest threat to general practice is that it would fundamentally change the relationship between doctor and patient.

Financial gatekeepers
'GPs will move away from being advocates of the patients sitting in front of us to become the financial gatekeepers of the commissioning group. We have to manage resources effectively and carefully but we are not here to act as rationers for the government.'

This presents a major challenge to the GPs leading the new commissioning groups, says Dr Gerada.

'The groups will need to put systems and structures in place to allow us GPs to practise medicine within an ethical framework. Their job should be to set the direction of travel while leaving us as providers to develop services for our patients.

'But if they over-manage or over-control, it will be a disaster for general practice.'

She also wants to see strong leaders in the profession who 'talk up' general practice: 'You will never hear me talk down general practice.

'Our leaders must always support generalism and general practice, and aim to improve professionalism, rather than just blaming us - there are enough other people around to do that.'

Key challenges for gps

Dr Gerada identifies a series of key challenges GPs face:

  • Health Bill By forcing GPs to become financial gatekeepers, it could fundamentally alter the patient-doctor relationship.
  • Loss of generalism GPs must hold on to their generalist role, but will need additional training to do so.
  • Revalidation GPs must demonstrate their competence and professionalism through revalidation, and the college is pledging to make the process as 'do-able' as possible.

Passion for generalism
Generalism is a passion for Dr Gerada, and one that has borne fruit in the recent thought-provoking report from the college's commission on generalism, a joint initiative with The Health Foundation (GP, 14 October).

'We need to hold on to our generalism as long as we can,' she says. 'But we need enhanced training to do so, and without it we will find practising our profession increasingly difficult.'

It is also vital, she says, for GPs to be able to demonstrate their competence and professionalism to the public - which is where revalidation comes in.

'We are making it as do-able as possible for the profession. But we all have to do it because we need to demonstrate to the public that we are maintaining standards.

'And I have absolutely no doubt that 99.9 per cent of the profession are fantastic and will pass.'

In August 2012, the RCGP's 60th year, Dr Gerada expects to open its new headquarters in Euston Square, London.

'It's an enormous step for the college,' she says. But in symbolic terms, what does this development say about the current state of the RCGP?

'While we might not be the oldest of the medical colleges, we are an influential body and one that is growing and doing good for general practice and medicine around the world. It says we are a force.'

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