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The value of general practice - Letter to the profession

26 January 2007

Dear Colleague

At a time when GPs and the wider NHS should be celebrating the achievements of general practice we seem to be facing a constant barrage of unjustified and, at times, malicious criticism.

Following the introduction of the new contract, most GPs have seen a significant rise in their incomes, the popularity of general practice as a career option is increasing, practices are demonstrating high quality, evidence-based care and survey after survey continue to confirm the public’s trust and confidence in GPs.

Yet general practice is under huge pressure. Not only are we experiencing an unprecedented volume of misinformation, half-truths and politically-inspired doctor-bashing, we see the threat of the advance of the private sector, the increasingly desperate measures as primary care organisations (PCOs) seek to balance their books and, of course not least, the government’s attempts to renege on aspects of the contract deal, particularly the current attack on GP pensions.

Most of these problems affect all GPs in the UK and this is a time for the GPs in all four countries to stand together to defend our profession.

I’m writing to tell you what the General Practitioners Committee (GPC), together with the BMA, is doing and will continue to do, both to promote the values of UK general practice and to protect and defend us from these many threats.

We have vigorously responded to the many anti-GP stories that have appeared during recent weeks, with letters to the press, appearances on radio and television, frequent briefings for both the lay and medical press and even a personal call to the Secretary of State to express our outrage at the most recent suggestion that GPs’ pay might be capped. The BMA’s press and parliamentary divisions have been tireless in their efforts to get our message across to both the public and politicians.

On the funding of next year’s contract, we have not been able to reach agreement with NHS Employers as we believe what has been offered so far would further erode the gains we have made on behalf of GPs. In accordance with our usual practice, we submitted evidence to the Doctors and Dentists Review Body (DDRB). The government has suggested that the DDRB does not now have a role to play in determining GP pay. We fundamentally disagree with this, are awaiting the DDRB’s decision and will seek to ensure that GPs’ rights to an independent consideration of their incomes are protected.

On pensions, we are well down the road of pursuing a judicial review on the unacceptable decision by the Secretary of State to cap the GP dynamising factor in direct contradiction of the deal we agreed and GPs voted upon. We know just how angry GPs are at this fundamental breach of faith on the part of the government. The legal process can be time consuming but you should be in no doubt of our determination to seek a successful conclusion to this matter. We will consider every means open to us to fight this battle.

There are other wider threats to the NHS, many of which are related to the English department’s obsession with “plurality, competition and contestability”. We believe this means increasing privatisation and risks handing well-run and established services to untried businesses.

We continue to promote the values of UK general practice. Despite the predicted, planned and subsequently delivered increases in funding, UK general practice is still highly cost effective, demonstrates high quality, delivers a much more comprehensive service than most of our European counterparts and, crucially, continues to protect the NHS from more expensive secondary care. We are working within the BMA, and are in talks with independent researchers, to quantify and promote the value of the work that we do. This work will help us not only to meet the criticisms we face head on, but also to emphasise the huge contribution GPs make.

The government may feel that by blaming GPs they will divert attention from where the real blame lies. They couldn’t be more mistaken. They need a confident, cooperative general practice more than ever, if they are to have some chance of getting the NHS out of its present shambles and their persistent denigration of GPs and their value is completely counter-productive. They will not impress our patients, their voters.

Of course, we can always do more. We continue to look at other ways by which we can get our message across. Accompanying this letter is a fact sheet to help you and your colleagues respond to the criticisms and misinformation surrounding the work that we do. Despite all the negative press we know that the vast majority of the public retains confidence in “their GP” and “their practice” and will trust us to tell the truth. I would encourage individual GPs and local medical committees (LMCs) to make contact with their local media and local politicians to promote the work that they do and to ensure that they put them in possession of the real facts.

Lastly, and most importantly, general practice is judged by what we do, the way we treat our patients, the consideration, dedication and compassion of a caring profession. I am confident that these values remain as strong as ever but it is vital that we don’t allow the present distractions to affect the core values of the work that we do.

I want to reassure you of my commitment and that of my GPC colleagues to respond to the challenges ahead with energy, rigour, persistence and determination. I know I can count on you to ensure that that commitment is strengthened by the excellent service you continue to deliver to your patients.

Best wishes

Hamish Meldrum
Chairman, General Practitioners Committee

Read the fact sheet here