'GPs are prized asset' say the Lib Dems

Liberal Democrat shadow health secretary Norman Lamb says that, a year into the post, the 'fog is beginning to clear'.

It's good timing, because he has plenty to digest with the release of the final report of Lord Darzi's NHS Next Stage review last week.

Clutching a can of Coke, he meets the small delegation from GP himself at the doors of Portcullis House, in Westminster, his London office base.

Norman Lamb

The rhetoric of the Darzi review, he says, is difficult to disagree with.

'Quality, clinical engagement, prevention, access to information, giving patients real power - all that is really good. But just saying it doesn't mean it will happen.'

He says that although the language and tone of the document suggest a major shift of emphasis, it is unlikely to materialise.

Both Labour and the Conservatives, he says, support 'rather a centralised system', despite much talk of devolving power.

'The government has showered largesse on the NHS, and yet GPs tell me they feel a loss of clinical responsibility and control.'

GPs, he says, tell him that they feel emasculated by the endless diktat from Whitehall.

The simmering row between doctors' leaders and the government, he warns, has reached the point where it is damaging patient care.

He believes, however, that there is a case for reforming incentives for general practice.

'There are variations in quality, particularly in some of the inner-city areas.

'We think that just as in education there should be incentives for schools to bring in children from disadvantaged areas, there could be similar principles in healthcare, not to force but to incentivise GPs to provide treatment and service to disadvantaged areas, to set up branch surgeries and so on.'

He blames MPIG in part for this, and says the funding wrapped up in it could be redirected to support the new incentives.

But he adds: 'I realise it's a difficult transition - you can't leave practices high and dry who have come to rely on the MPIG to support the services they are providing.

'We have got to find a way of developing a transition from a system based on historical failures to one that encourages preventive work through the quality framework, but also incentivises GPs to take on patients from disadvantaged communities.'

But Mr Lamb is cautious - he recognises that the UK's family doctor system is an 'enormous prized asset' and admits there is a danger that in changing it, the 'baby may be thrown out with the bath water'.

For one thing, he says he is 'wholly opposed' to the imposition of polyclinics from the centre, whether by government or PCTs.

He points out that the threat is nothing new, however - pulling out a leaflet circulated when the NHS began, he reads: 'Doctors may be accommodated in health centres instead of their own surgeries ... what goes around comes around.'

Earlier this year, the Liberal Democrats opted not to back GP's Valuing General Practice campaign, but Mr Lamb has no hesitation in offering his support for all its principles when they are read out to him.

GPs may wish other parties would follow suit.



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