Brown Warned His ‘Flagship NHS Policy Could Fail’

In a fighting speech to the UK’s family doctors’ conference, GP Chairman Dr Hamish Meldrum sent a warning message to the incoming Prime Minister. Unless Gordon Brown clears the obstacles out of the way, the government’s flagship NHS policy of cutting patient waiting times to 18 weeks will fail.

Dr Meldrum, chairman of the BMA’s GPs Committee, in his keynote speech to the 2007 Local Medical Committees Conference in London, said the health department had announced that under its flagship target almost half the patients needing hospital treatment already received it within 18 weeks of seeing their GP. He said:

“But if Gordon Brown wants his flagship to reach port he’s got to clear some of the obstacles in its way. Getting the other 52% of patients treated within 18 weeks is going to be much harder work – it’s always the easier ones first. All doctors want to see this become a reality for all patients. We want to see it work.

“But there’s wreckage around that could sink the ship – referral management centres that ration healthcare, choose and book that doesn’t work, practice based commissioning blocked at every turn, the junior doctor training fiasco, and, affecting everything, the grinding year-on-year cuts that prevent investing to improve.

“The message is clear, the doctors are prepared to crew your flagship Gordon – but only if you work with us, get the minesweepers out and remove the obstacles in our way.”

It had been a difficult year of change, with more to come, said Dr Meldrum, who represents the UK’s 44,000 GPs. On Practice Based Commissioning, although he would like it to succeed, he said “Given the lack of support and the uncertainty about budgets and data accuracy, I don’t blame practices for being, at best, lukewarm and, at worst, not wanting to touch it with a barge pole.”

Referral Management Schemes all too often operated at their worst and were described by Dr Meldrum as “a very thinly disguised form of rationing that act as a Berlin Wall to patient choice.” He continued: “Choice” – there’s another example of a concept that’s fine in principle but which has been shamefully corrupted in practice.”

Dr Meldrum spoke of the attacks on those practices working under Personal Medical Services (PMS) local contracts. He warned that the present witch hunt by certain Primary Care Trusts (PCTs) was not only unfair to practices, ”it seriously risks damaging services to patients.”

Changes to the NHS over the past year came in for sharp criticism from Dr Meldrum. He said: “All these changes have not been good news for the Secretary of State, not good news for doctors and they don’t seem to be good news for patients. And to add to the litany of problems we have the extreme measures that many PCTs have taken to try to save their own necks and Patricia’s job. Delayed operations and outpatient appointments, redundancies amongst staff, ward closures and the slashing of training budgets. No wonder so many doctors and patients alike have lost confidence in this government’s disastrous management of the NHS.”

This year’s zero funding award for GPs was an insult, said Dr Meldrum. “It failed to recognise that an award is more than just about paying GPs. It’s about paying our staff, paying for our premises, resourcing the very nature of the work that we do – providing outstanding, high-quality care to the patients of the United Kingdom.”

Echoing the title of the conference – Changing times. Constant values, he said “Of course general practice has changed and continues to change and it’s true that in much of the government-inspired, meddling nonsense that is today’s NHS, so many of these changes are not changes for the better. The avalanches of unnecessary bureaucracy, the dogma-driven rush to privatise the NHS, the corruptive aspects of the internal market – no wonder there is anger and despair. But the values that we hold dear, that are the essence of general practice, remain constant and unchanging.”

For younger doctors there was for the first time in some years the real prospect of GP unemployment or at the very least the inability to find GP partnerships. Dr Meldrum called upon UK GPs to encourage younger colleagues and to offer partnerships. “You don’t just owe it to our young colleagues, you owe it to yourselves and to the future of our profession.”