Welsh health minister told 'must try harder'

GPs in Wales think their health minister, a former GP, could make more of a difference. Prisca Middlemiss reports.

A year after GP Dr Brian Gibbons replaced Jane Hutt as health minister for Wales, how much have GPs there benefited from one of their own heading up their health service?

GPs were pinning their hopes on Dr Gibbons in January 2005 and today, the minister's confidence remains undented.

'My biggest advantage was that I was able to hit the ground running.

I knew a lot of people in the NHS and in the health service trade unions,' he said.

Dr Gibbons insisted he was on target to deliver maximum one-year waits for inpatient treatment and outpatient appoint- ments by March 2006.

While he admitted that 'any health minister who says they have got enough money hasn't understood their portfolio', he said the money was there 'to lead to the radical transformations that will improve the patient experience significantly'.

He added: 'I am most proud in my first year of turning round the perception that the NHS in Wales was a second- or third-class service, which could not compete with England and was in terminal decline.'

Good communicator

Dr Gibbons may be pleased with his performance so far, but GPs in the principality are doubtful about the benefits.

Morgannwg LMC secretary Dr Ian Millington conceded that Dr Gibbons 'brought helpful qualities: a good communicator, he understood the clinical issues, he has worked in deprivation, he is a caring professional. We are able to talk GP to GP.'

But Dr Tony Calland, a GP in Monmouthshire and chairman of the BMA Welsh Council, said: 'From a BMA perspective, I am disappointed that he hasn't used his experience of front-line medicine more effectively. He knows the difficulties GPs face when they can't get patients seen in secondary care. Waiting times are as bad as, if not worse than, a year ago and he is not hearing what professionals tell him.'

Greater input

Dr Calland said he would like to see 'greater input from front-line professionals on policies' within a year. He gave Dr Gibbons 7/10 from a GP's perspective and 6/10 with his BMA badge on.

Wales has been a step ahead of England on some issues. Enhanced services are negotiated centrally and local health board (LHB) spending pledges have been honoured.

Dr Andrew Dearden, chairman of GPC Wales, said: 'The Welsh Assembly has chased the LHBs to ensure that the money put in has been used to develop primary care services.

'All of our LHBs will have spent to the enhanced services floor this year and probably one LHB in three will have exceeded their floor.'

However, disease prevalence and the quality framework are concerns for the 1,816 GPs working in Wales.

'We are doing 10 per cent more work than in England and earning 10 per cent less,' Dr Dearden said.

However, Dr Gibbons said: 'GPs have been well rewarded for their work and the attainment has been way beyond what was expected. It's a bit tortuous to argue that GPs have lost out with prevalence when we have ended up spending more than expected.'

Overall, Dr Dearden rated Dr Gibbons' first year in office at 7/10 for enhanced services and 6/10 for accessibility. He gave him 3/10 for delivering on practice premises.

Last month the Conservative Party in Wales called on Dr Gibbons to reconsider his position if he missed his waiting time targets in March. His GP colleagues may not be so hasty.

Dr Calland said: 'I don't think Dr Gibbons should reconsider his position, but he should reconsider what he is doing in that position. He's as good as anyone available. But I think that he does need to be more energetic about changing things that will make a difference.'

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