Lord Darzi has listened to us, says RCGP chairman

Interview - Professor Steve Field talks exclusively to Colin Cooper.

Professor Steve Field
Professor Steve Field

When Professor Steve Field became chairman of the RCGP in November, he expected revalidation to be the defining issue of his three-year tenure.

But then a certain Lord Darzi came along, swiftly followed by an international health scare.

At the time, norovirus was the more pressing issue. Within three days, the new RCGP chairman had given more than 100 media interviews.

'It gave me an entry into the media very quickly and really established the college from a media point of view,' he says.

'This was important because we wanted to really emphasise that the college is the heart and voice of general practice. We work closely with the GPC and others but we want to comment more on political issues.'

Lord Darzi's review gave Professor Field the perfect opportunity to push forward on the political front, able to influence the review from the inside while the GPC was largely confined to shouting from the sidelines.

'The environment was very negative to GPs at the time but we were able to have quite an influence on the primary care strategy, even up to the day before it was printed.

'And while it's not perfect, it's still very supportive of general practice and sets out a positive role for GPs.'

Lord Darzi is a good listener, says Professor Field. 'When I first met him I was worried that he did not have the knowledge or experience of primary care, but he has listened.

'He probably rightly had a bad press to start with, but now he is promoting federations of practices and supporting our way forward very strongly.'

The federation model also allows Professor Field to 'challenge some of the sacred cows of general practice', as he puts it. For example, he believes single-handed practices working in isolation will no longer be tenable.

And he agrees with Lord Darzi that recruiting GPs to the inner cities is difficult, that the quality of service is variable, access is poor, and some areas need new health centres. As an inner-city GP in Birmingham, his views are informed by experience.

His passion for reducing health inequalities also gives him common ground with health secretary Alan Johnson. 'I have spent quite a lot of time talking with him and have been very impressed.

'He does not pretend to be an expert. And from a politician's point of view, I think he has been a good health secretary.

'That might be difficult for college members and fellows, but we have to rise to the challenge.'

What concerns Professor Field is how the theoretical plans for reform are implemented on the ground.

As a result, the college has organised a network of fellows around the country to feed back information on regional developments and produce a co-ordinated response.

Building bridges with the GPC has also helped win its support for the college's controversial practice accreditation scheme.

Will the same support be forthcoming on revalidation?

'It's complex, politically sensitive and educationally sensitive. But we are spending a hell of a lot of time in meetings with stakeholders and doing a lot of work on how to assess performance, because we want a system that is supportive rather than punitive.'

This is one issue that will certainly test Professor Field's communication skills.


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