The Elephant in the room.

Yesterday at the 2014 RCGP annual conference in Liverpool Jeremy Hunt took questions from a variety of GPs are part of one of the opening sessions. A link to the video footage can be seen here.

Some questions such as those posed by Mark Purvis (@purmj) challenged the information provided by the Secretary of Health and even questioned his honesty.

However the question that has reverberated across the country with numerous sound bites and created more questions, was posed by Dr Stephanie de Giorgio (@DrSdeG) a GP in Deal as shown below:

Mr Hunt. There is an elephant in the room well known to all who actually work in general practice. This is the ever increasing inappropriate demand from patients. Instead of addressing this, you and the press make it worse by continually denigrating general practice and encouraging patients to be ever more demanding. We are exhausted, drowning and quite frankly furious with you. What are you going to do?’

Followed by a round of applause the Secretary of Health attempted a response.

I do believe we have to respond to the changes in the expectations of the public

This can be agreed by most, the pertinent question is how?

One of the reasons we have such huge pressures in A&E departments is because the public are saying that if something goes wrong on a Saturday morning that they don’t want to wait till Monday or Tuesday to see their GP to sort it out

This may be true in some cases however there was no comment on the original question about tackling the rising demand fuelled by Government, public health and third party campaigns which make patients attend with health issues that should be managed by self care.

if General practice is going to be at the heart of modern NHS

If? If? Really? A subconscious slip about the Secretary of Health actual views or a term of phrase?

What I would disagree with….is that I am not fully behind GPs….I have always talked about a stronger role for General Practice

I agree, Jeremy Hunt has talked. Unfortunately it has only been talk with very little action to back up the words. Actually most actions have been counter-productive to his talk.

I have always campaigned for more resources to go into out of hospital care

Please compare funds made available last year via campaign initiatives to A&E departments (£500million) versus funds made available for primary care (£50million Challenge fund). Additionally primary care has seen a progressive reduction of real term funding (now less than 9%of the NHS budget for 90% of the work) since the coalition government has take hold. As above: talk no action.

and I have tried to make a start to some of the changes to the contract that have made it more difficult

This would include dementia screening with little evidence base of overall benefit to patients and the administrative nightmare that is the Unplanned Admission DES, all which have repackaged funds taken away from the original primary care budgets.

I have concluded that in the end there is a very big capacity problem, so what you talked about in terms of burnout worries me a lot

And yet again no comments on actions or plans to address the fact that General Practice is seeing marked loss of working GPs due to early retirement, emigration, administration roles and change of career, including a growing trend of failing to attract new trainees to the speciality.

Personally I feel Jeremy Hunt failed to impress at the conference. He failed to allay any fears that his policies are designed to help primary care, GPs and ultimately patients. As an observer it was frustrating to also see a lack of challenge or rebuttal to his responses by the Chair of RCGP Maureen Baker (@Maureenrcgp) which has taken a different stance compared to previous Chairs.

We need change.

We need to educate, communicate and back Primary care.

We need #1careRevolution


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