If anyone expected the next chairwoman of the RCGP to be overawed following Professor Clare Gerada, think again. Dr Maureen Baker has come out fighting.
After spending a decade in the role of RCGP honorary secretary, it would be easy to label Dr Baker as purely a back office operator.
But this Scottish-born GP is proud of her record of being a nationally elected member of council three times in a row, and recently declared at the hustings that if elected, she would run to chair council.
A glimpse of her character can be seen in the revelation she experienced as a junior doctor in Scotland that prompted her to opt for general practice over paediatrics.
'As a junior doctor I found that I could not deal very well with being told to do something that I did not think was the right thing to do. I realised that I might have difficulty with hierarchies and instead, went for the independence of general practice.'
Reclaim the consultation
The Lincoln GP has two major tasks at the top of her to-do list, for when her three-year term as chairwoman begins in November.
First, Dr Baker aims to bring about the shift of resources into general practice that has been talked about for years but has yet to materialise.
Second, she wants to reclaim the patient consultation from the policymakers, who she fears are turning the core activity of general practice into a tick-box exercise.
'The pendulum has swung too far towards the managerial view. By the time you have done all of that, the patient's agenda has been squeezed. How is that good patient care?'
And of course, it is the continuing lack of investment in general practice that means so many GPs are now struggling to maintain standards in the face of a rapidly increasing workload.
'The perception seems to be,' says Dr Baker, 'that general practice is there to serve every other part of the NHS, whereas actually, general practice is there to serve patients from the cradle to the grave. It's the foundation and the more we chip away at that, the more likely we are to see poor outcomes.'
She points to year-on-year falls in actual spending on general practice over the past six years, while other parts of the NHS have received increases in funding.
'It's not necessarily a strategic decision but the overall effect is starving general practice of resources and putting GPs under increasing pressure.'
Bolster the workforce
This ties in with the RCGP's 2022 plan for general practice, which calls for an extra 10,000 GPs to bolster the primary care workforce.
And there is a growing sense of injustice at the college that general practice now carries out 90% of the work in the health service on just 9% of the budget.
Which is why Dr Baker found it so hard to take when the NHS recently returned a £2.2bn 'surplus' to the Treasury: 'Why was there no consideration of how we could use that money in the health sector? I find that very difficult to understand.'
The controversy over failures in A&E services is a case in point. The government blamed general practice, then gave an extra £500m to secondary care as a short-term fix.
'This is what I call voodoo health economics. It's the wrong use of the money in the wrong part of the health sector,' says Dr Baker.
'I'm asking for a 10% increase in funding for general practice, which is £700m. So £500m would have been a big part of that, and there is clearly money available in the system. You could throw indeterminate amounts of money into the acute sector and they would mop it up, whereas a relatively small amount of money would reinvigorate general practice and help the whole healthcare system.'
Dr Baker is beginning to sound like a medico-politician. Is she straying away from the traditional RCGP remit into BMA territory?
'It would be fantastic if the BMA were to say the government should take money from one sector and give it to another, but it has to represent all disciplines.
'The college is concerned with general practice alone. We are concerned about standards of general practice for patients. So we have every right to make the case that general practice in this country needs proper funding to ensure adequate care for patients.'
The NHS reforms are a threat to the standards of general practice, says Dr Baker, who believes the college has a role in monitoring the impact of the changes on care and the morale and effectiveness of GPs.
'The reforms are here and it would not help patients if we just packed up and went home. So we have to find a way of working through the system with as much enjoyment in our professional lives as possible.'
Dr Baker loves 'meeting people' and says the RCGP's annual conference is one of the highlights of her year. She hopes to improve communications with the whole college membership during her time as chairwoman.
'I want to have a more direct relationship with the membership. I would like to see a more meaningful and constructive dialogue between the college and the membership. Because the college is its members.'