From a steel town to striking gold in China: the RCGP secretary's first year

Professor Nigel Mathers discusses the many opportunities and controversies of his first year as honorary secretary of the RCGP.

Professor Nigel Mathers (Photo: Pete Hill)
Professor Nigel Mathers (Photo: Pete Hill)

To be honorary secretary of the college is not a job for the faint-hearted. Taking responsibility for responding to more than 100 consultations a year, on subjects as difficult as care.data and female genital mutilation (FGM), requires nerves of steel.

So it’s appropriate that Professor Nigel Mathers, who was elected by council last November after a successful stint as joint vice-chairman of the college, forged his career in a deprived area of Sheffield.

Professor Mathers has spent the past 25 years building up the practice that he took on as a single-hander, but recently left to ‘see what it’s like working in a different type of practice before I retire’.

His experience as professor of general practice at the University of Sheffield and head of department, managing a team of 20 staff, has also proved useful in his key role of ensuring the college and council are run according to governance arrangements.

Professor Mathers is on secondment from the university for the two days a week that the secretary’s role is supposed to take up, although inevitably it has turned out to be more like a full-time job.

Controversial issues make for a challenging role

‘It’s a challenging role, but I love it. It gives you the chance to do all sorts of interesting things, such as appearing before House of Commons select committees,’ he says.

One of the most controversial issues during his first year has been FGM, particularly as the college has been ‘a lone voice crying in the wilderness’, as he puts it.

‘We have an excellent policy. FGM is a safeguarding issue and the existing legislation is sufficient to address it. But we have to make the legislation work better, providing opportunities for training and raising awareness.’

But the government wants to introduce a new law, making it mandatory for GPs to report all cases.

‘If I see a 50-year-old woman with a gynaecological problem and I see she’s had FGM, under the proposed law, I would have to report her to the police, even if it was done 30 years ago in another country.

‘She would go to the police station for the diagnosis to be confirmed by another doctor. The police would then decide if a prosecution needed to take place. This has not been thought through. We need a different approach for adults. The college has been in a minority of one on this issue but people are starting to move in our direction.’

Tackling the government's plans for care.data

The controversy over care.data also ‘took up an enormous amount of energy’, but was another matter on which the college was able to change opinions.

‘The leaflet was completely hopeless and the college played a major role in securing a pause in the whole programme. We are now having regular meetings to ensure the ethics and science are right and the professionals are on board.’

Professor Mathers has been particularly inspired by his role as convening chair of the Coalition for Collaborative Care – a group of 200 organisations and individuals dedicated to improving the quality of care through care planning.

The college has just appointed a full-time director to run the initiative and GPs are trained for free if they go on to train colleagues and implement care planning in their practice.

‘There is a huge consensus now that we have to transform the way we work with people with long-term conditions,’ he says.

‘Care planning is so profound and transformative, the overwhelming majority of doctors who go through it do not want to go back to the old ways.’

Taking to the streets for general practice

Professor Mathers has also found time to take to the streets of East London in protest against the phasing out of the MPIG, which threatened the existence of local practices.

‘It’s a scandal that 100,000 people would have had their medical care withdrawn. We agreed to support the campaign and played our part in getting a two-year stay of execution.’

Further east, China has also been a regular destination for Professor Mathers this year, as he has made a number of trips there to help consolidate the college’s work in training GPs, and he returns this month to present a lecture in Chinese.

‘They want the NHS in China. They see the benefits of the gatekeeper role,’ says Professor Mathers. ‘To the Chinese, the college is the golden brand.’

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