Dr Copperfield considers the impact of industrial action on patients
I’m writing this just before the result of the ballot on industrial action. And I’m going out on a limb here, but I reckon GPs will be in favour.
There’s one thing I’m less clear on, though. Why, as D-day approaches, does the message to the public increasingly seem to be, ‘this won’t hurt patients’?
I’m all for keeping patients onside. But not at the expense of logic or possibly even facts.
If I was Joe Punter, my interpretation of ‘do no harm’ in this context would be pretty simpleton. GPs go on strike. Apparently no one dies. No one comes to harm. No one notices. No point in GPs. Which, of course, gives more momentum to the shitty, easy access, all-u-can eat noctor service over the high quality GP service you currently have to wait or beg for.
Besides, how valid is the reassurance that we’re harming admin rather than patients? Aren’t the two inextricably linked? Refusing to use the prescribed referral proforma leads to an interminable battle and delays (been there, done that). Ditching A&G means referrals get bounced or just elicit advice anyway, so ditto.
In fact, scanning the suggested ten acts of the draft industrial action script suggest that the disclaimer ‘No patients will be harmed in this production’ would be wrong 4/10 of the time.
In particular, there’s that cap on appointments. OK, maybe I’ve only got an infected ingrown toenail. But if I can’t get a GP appointment, I can opt for the purgatory of 111 or A&E as the throbbing increases. Or I can just sit and wait and hope that I’m not the needle in the haystack that goes all sepsissy and dies. True, the public are pretty health illiterate but even they know death is harmful. And yes, that is an unlikely example, but other medical disasters are available.
And what about the argument for continuity, which grassroots and leaders have been banging on about, correctly, ad nauseam. That’s why we want more GPs/smaller lists, right? Because it’s safer for patients? Capping appointments makes it harder to see the same doctor. So is the argument for continuity discontinued for the duration of the action?
Maybe we should stop trying to soften the edges. Patients being harmed? Durr, it’s happening already. Industrial action can only make that worse in the short term, but that’s a price worth paying to avoid a cataclysm in the future. In the meantime, I guess that toenail could probably see a chiropodist.
Dr Tony Copperfield is a GP in Essex. Read more of his blogs here
Nice. But we should have also taken the opportunity to give the government a checkup. Open wide Mr Govt, this salty purgative will cleanse you, of all the lies you’ve told, “there you go, throw it up, son”. An enema administered by ARRS to help get rid of all the crap, you’ve been dumping on us. Leeches (but not Gove) to rid you of the poison circulating around in your systems. Oh, and some trephining (why not? it’s free on the NHS), to calm your the fevered head.
Is all this gonna hurt? You bet it is…
Just on a technicality this ballot is not about industrial action, it is about collective action to work in line with our contracts on one or more of a range of options. Obviously those who can’t face stopping any voluntary work will have voted against collectively working in line with contracts and that is fine. We will see what the indicative ballot indicates and then see what GP partners & sole contract holders do.
The prevailing undercurrent wrongly in my opinion is that ALL GPs need to stick together to act as one group in any industrial action.
Wrong in my opinion .
The majority do need to stick together but recognising the world is never as it seems- we need to act in 2 broad distinct groups as has always largely unrecognised in my view, been the case.
The majority of GPs need to act together in industrial action where thought through and agreed and distinctly from the smaller cohort of duplicitous self-serving GP PCN CDs/ ICB GPs / GP NHSE GPs with occasional clandestine LMC GPs acting in alignment with the government as has always been the case .
Of course, there will be many exceptions as we all accept, but we already know the tendency of leaders to progress in their desired pursuit of increasing status in many cases and adopt similar positions to their counterparts due to affinity bias.
Once this fault line is recognised among GPs however insalubrious, then there will be progress through greater alertness and the prevention of the deceptive disingenuous supportive tones from some within these groups being taken at face value.
To overlook this, leads inevitably eventually to betrayal by these groups as seen by highly remunerated PCN CDs effectively closing the door to GP colleagues in configuration with the government and undertones of dissent arising from these smaller GP groups who have profited immeasurably over the decades from the demise of their colleagues( and patient care in my opinion) through their artful double-dealing.