Saturday 29 October, 3.30pm until 5.00pm, Henry Moore Gallery
Proposals in the recent Health Bill to change the role of GPs have been among the most contested of all the coalition’s policies. David Cameron cited GPs’ frustration with NHS bureaucrats as a core motivation for putting them in the driving seat, responsible for commissioning most healthcare and in charge of huge budgets. Yet while some rejoice at the prospect of the medical experts having a greater say in deciding how best to allocate resources, others worry GPs will see their professional authority undermined if they take on managerial roles on top of their medical responsibilities. Meanwhile, frontline healthcare is increasingly being provided by ‘nurse practitioners’ and call-centre surgeries such as NHS Direct; even pharmacists now provide vaccinations and routine health checks.
Whatever happens to the current Health Bill proposals, there is little doubt the role of doctors has been changing for some time. The increasing focus on public health and preventative medicine means GPs are no longer asked simply to treat sickness, but to help prevent healthy patients getting ill in the first place. Patients’ diet, alcohol intake, smoking habits, weight and level of exercise are now considered to be doctors’ main focus, to the extent that recent NICE proposals could see GPs paid more depending on how many patients they encourage to stop smoking. Some surgeries are now setting up shop in supermarkets to attract doctor-shy shoppers and foster greater public awareness of healthy living. At the same time, the ever-greater scope of the Quality and Outcomes Framework means GPs are required to probe ever deeper into patients’ health and lifestyles beyond their reported illness.
Have these changes really been thought through and debated sufficiently by doctors, or simply nodded through with a shrug? Are the new roles empowering or, as the Kings’ Fund suggested in 2010, has the medical profession lost confidence in itself? Are GPs undermining the doctor-patient relationship by trespassing into lifestyle areas previously considered private? Why have GPs’ roles become such a political issue? How much does it have to do with current economic uncertainties and public sector cuts? Are doctors being turned into bureaucrats, rather than liberated to get on with their medical responsibilities?
Listen to session audio:
|Dr Clare Gerada|
GP; chair, Royal College of General Practitioners
|Dr Maggie Helliwell|
GP; vice-chair, National Institute for Health and Clinical Excellence (NICE)
publisher, nhsManagers.net; writer and broadcaster on health and NHS issues
graduate medical student; freelance writer on pharmaceuticals, healthcare and science; co-founder, Sheffield Salon
development manager, Do Good Charity; former NHS health visitor and senior manager
Health secretary announces a fifth wave of pathfinder commissioning consortia, while defending his criticism of bureaucracySA Mathieson, Guardian, 9 July 2011
In the past, attempts by the state to prevent the consumption of alcohol were known as prohibition. Now they’re called ‘promoting public health’. The ultimate goal is the same though: the diminution of our rights in the name of ‘the public good’.Max Klinger, spiked, 8 July 2011
Dr Hamish Meldrum, the chairman of the British Medical Association, said the suggestion under revamped plans from the health secretary, Andrew Lansley, might lead to allegations that doctors were withholding patient treatments and referrals to increase their pay.Rajeev Syal, Guardian, 28 June 2011
In the UK today social disadvantage results in vast gaps in health and mortality, but these inequalities are not inevitable. A new report from the Royal College of Physicians (RCP) in partnership with leading health organisations and the NHS calls on all doctors to make addressing the social determinants of health part of their everyday medical practice, reducing where they can the inequitable burden of disease.Bob Davidson, Total Health, 11 June 2011
The recent root -and-branch reforms of the NHS also have profound implications for the future of general practice, in particular the dual role it is being asked to play as both commissioner and provider of care that will mean GPs taking on responsibility for costs as well as outcomes of care. The timing of the inquiry’s report is therefore propitious. General practice is at centre stage and quality must be the watchword.The King's Fund, 24 March 2011
Decisions about prioritising resources have to be made, but, given the role of doctors and the importance of trust, they should not be made by GPs. Like anyone else working in the NHS, GPs should be aware of these decisions and their difficulty. But, if anything, the GP is, and ought to be, the patient’s advocate in this process.Mark Sheehan, BMJ, 11 March 2011
GP frustration with the NHS, the profession's desire to do more and be more involved is the motivation behind the Health Bill, according to prime minister David Cameron.Neil Durham, GP, 28 January 2011
The NHS is going to be dismantled by using the market forces of ‘creative destruction’. This will have profound effects on the medical profession with attacks on T+Cs, pensions, medical training, professionalism. More importantly, the knock on effects for patient care will be devastating.Clive Peedell, NHSCA, 5 January 2011