When having patients is a failure

Confucius cursed his enemies that they might live in interesting times.

In Suffolk things are so interesting that we begin to wonder if we did something terrible in a previous life.

Cuts. Massive, hideous, cuts — for the three practices in our town one eighth of income is slashed. A 10,000-patient practice must cut back to four doctors, losing the extra one and a half it gained two years ago when the list size was too high.

Now the (increased) list is considered too low, due to an unfortunate but bruising encounter with Carr-Hill. We have 10,000 of the wrong sort of patients — they consult, it seems, more often than expected.

Of course we’re fighting it, even in this divided county (the GMS practices are still lined up on the other side of the wall waiting to hear what’s in store for them). But, faced with our fury at the loss of the equivalent of four doctors in Haverhill, the PCT claims it has seen no results for its increased spending in primary care.

The thousands of extra appointments and massively shortened hospital waiting times count for nothing. The extra and earlier diagnoses, the excellent terminal care, the fast-track clinics. the near perfect quality framework scores against a nationally predicted 650 — that’s not performance at all.

Now knock me over with a purple jockstrap if this makes no sense, but who says that’s not performance? Its measure of performance seems to be that we refer no fewer people to hospital than before — we haven’t saved it money — yet who agreed that that was a measure of excellence?

I suspect attack is the best form of defence. Nobody will stand up for us but ourselves. Time for GPs to form our own press office and launch a campaign to save general practice, perhaps? I’d start it, for sure. I’m ready, as Gordon would say, to serve.

These are indeed interesting times.

Dr Selby is a GP in Suffolk. You can write to her at GPcolumnists@haymarket.com

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