Dr Burnt Out looks to a classic superhero film to analyse the state of general practice
In the summer of 1981 I went to see Superman 2 at Swiss Cottage Odeon, while my sister saw the Agatha Christie film The Mirror Crack’d at the same time. We met up in the foyer afterwards and compared notes on both films.
I much preferred Superman 2 to Agatha Christie. I was particularly struck by the scene where General Zod (Terence Stamp in fine villainous form) and his two criminal cronies are imprisoned in the ‘phantom zone’ as a punishment, and sent spinning off into space for a presumed eternity.
The ‘phantom zone’ in the DC comic books was described as a prison, in which people can be trapped and incarcerated. It exists outside of the normal space/time continuum and is a ‘vast expansion of near-nothingness.’
Recently, I can’t help but think: has general practice not entered a metaphorical ‘phantom zone’? The seemingly disastrous Budget and the changes that will ensue from it have made general practice slip into another space-time dimension where basic questions are now being routinely asked:
How will doctors and staff get paid? How will new GPs get jobs? How can we deal with the immense, unending workload? How can I get through the day without wanting to shout at the computer as the EHR crashes for the fifth time?
How can I explain again that the wait for an ADHD assessment is over three years? How can I get yet another letter asking me to arrange and do secondary care’s work for them? How can I send yet another A&G into the electronic ether with no response? How am I supposed to supervise ARRS staff when the patients just end up asking to see a GP anyway? How did we end up like this?
How? How? How? Why? Why? Why?
I do not want to be too negative but these were questions that were not being asked, or even thought possible to ask, even just a few years ago.
I thought Wes Streeting and his Labour chums were supposed to be fixing general practice. They certainly weren’t meant to be aiming a very heavy sledgehammer to the basic structures and finances of practices, with the very essential financial viability of many practices now being brought into question.
What is the Labour Party’s endgame? Despite all the talk, this still is not clear to me yet – which is very frustrating in a time like this where we so urgently need clarity.
Is the plan these new ‘reforms’ seen in Cornwall of GPs being corralled into large salaried ‘call centre’ hubs, of electronic and digital GPs undoubtedly doing endless box ticking to improve appointment numbers, ‘outputs’ and ‘efficiency’ for the new Labour regime? Are we all going to be turned into avatars and become employees of the Tony Blair institute?
Is that the plan, Wes?
Be honest with us, Wes… help us out of the GP ‘phantom zone’.
Please, Wes… you are our only hope (oops, sorry I think that’s another late 1970s sci-fi film).
Wes has no plan and never had one. He has no idea what he is doing rather like the totally incompetent Labour government. I think they spent so much time in the opposition wilderness, they are institutionalised towards failure and inadequacy.
The plan is to abolish GPs as independent contractors.
“The independent contractor status of GPs has been an article of faith since the NHS was established in 1948. A salaried service was devised for hospital consultants but essentially, GPs have been self-employed ever since. This has led to the small business model of general practice and was at the heart of the partnership system.”
Labour plan to get rid of this. Wes doesn’t like GPs earning “money for old rope”. Fine by me. I’m happy to chuck the current miserable working model. I find out of hours an absolute joy and a complete doddle. When your normal morning involves e consults, labs, meds, Docman and upto 20 consultations then working for someone else seems an attractive proposition. It will be a painful and expensive transition.