Increasingly high hurdles for GPs to jump

Yet again, GPs are to have our standards challenged - and raised. This time the Office of Health Economics has recommended that the collection of data should now form part of professional medical standards.

In other words, we are to be given yet another hoop to jump through - as if we didn't have enough already. Every week it seems that GPs are being asked to do more, work longer and perform better.

We are increasingly being assessed - not just on our medical abilities, but on peripheral areas such as the warmth of our greeting to patients, whether we have offered a full choice of hospitals or whether we send patients copies of our letters about them. We are even judged on our behaviour outside medicine: our public conduct, our use of alcohol and our past criminal records.

If we fall short in any area, medical or otherwise, we risk being taken to task by the primary care organisations, the GMC, the DoH and the media. It's called 'adhering to high professional standards'.

Now I fully agree that GPs should have high standards in medicine itself. My concern today is subtly different: that doctors alone are singled out to conform to unimaginably high, wide-ranging and often non-medical standards while those around us go along in the gutter.

GPs are expected to be financially transparent: the DoH ignores the rules of mathematics when calculating disease prevalence. Practices have to obey all NHS contracts meticulously: the DoH can vary them at will. GPs have to obey draconian rules on data safety or face dire consequences: not so, it seems, for HM Revenue and Customs, the DVLA or the MoD.

Practices are expected to be meticulous over the quality framework and will be investigated if they have high exception rates. Meanwhile, hospital managers game waiting-time targets in A&E and out-patients, shamelessly bending the rules. Yet no managers are ever disciplined.

Why are doctors singled out for scrutiny while everyone else ignores the regulations?

So when MPs seem to have their snouts buried in the expenses trough, GPs are expected to be 100 per cent squeaky clean. Next year it will be raised to 110 per cent.

Dr Lancelot is a GP from Lancashire. Email him at

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