The blame game between Health Secretary Jeremy Hunt and GPs escalated last week as Dr Laurence Buckman, chairman of the British Medical Association (BMA) GPs’ committee, the doctors’ trade union, “accused the government of using the NHS as a political weapon”, says Heather Saul in The Independent.
Buckman said GPs were “overworked and strained beyond endurance” and attacked Hunt for making “childishly superficial and misleading” claims about the role of GPs in increasing pressure on overstretched accident and emergency (A&E) departments. Hunt defended his position, insisting that the problems in A&E are partly due to the ageing population, but also because out-of-hours care doesn’t work properly under the 2004 GP contracts.
It doesn’t work because the coalition replaced Labour’s successful NHS Direct service with 111’s “clueless call-centre operators”, swelling the numbers of patients referred to A&E by a third, says Polly Toynbee in The Guardian. There are also 6% fewer beds than in 2010 and 118,000 ‘bed-blockers’ waiting in hospital, unable to go home following deep cuts to social care.
The main reason for the “massive” increase in attendances at emergency departments around the time of the 2004 contractual changes is that those attending minor injury services and GP-led services located in emergency departments started to be coded as emergency-department attendances, says Dr Clare Gerada in The Independent.
Overall, A&E has experienced around a 1% increase year-on-year in attendances, but this reflects population increases. GPs have also been unfairly criticised for being “overpaid and not working hard enough”, says Gerada. Yet general practice is becoming ever harder as our population ages and patients present with more complex and multiple conditions.
GPs routinely see up to 60 patients a day (ten years ago that would have been exceptional). In general GPs, who earn an average of £60,000-£85,000 a year, work “jolly hard”. The idea that Hunt expects them to “assume responsibility for out-of-hours care too” is ridiculous, says Max Pemberton in The Daily Telegraph. GPs already work 60-hour weeks: “when would they sleep, let alone have a life”? Perhaps, but changes under the last government, embraced by GPs, have seen their wages rise and their hours shorten, says Anthony Daniels in The Sunday Telegraph.
Meanwhile, doctors also accepted financial incentives to take on bureaucratic, yet “worthless” tasks. No wonder “the chances of a patient seeing the same doctor twice in succession has become slim”, which unsurprisingly, the public has attributed to “the greed and laziness of GPs”. So Mr Hunt has a point – but only to an extent. After all, “the government acted as the Serpent to the medical profession’s Eve. And who is more to blame, the tempter or the tempted?”