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I AM THE DOCTOR… Dartmouth GP Dr Graham Lockerbie


WHEN I MET WITH DR GRAHAM LOCKERBIE, EMINENT DARTMOUTH GP AND PARTNER IN THE DARTMOUTH MEDICAL PRACTICE, I EXPECTED TO HAVE A HIGHBROW DISCUSSION ABOUT THE LATEST NHS REFORMS, SO I DID A BIT OF READING UP TO PREPARE MYSELF.


I


’d chatted to Graham lots of times before and knew I was interviewing a man held in high regard by the people of Dartmouth, passionate about his work and about getting the very best deal for patients. What I wasn’t expecting was a lengthy and enter- taining natter about the tussles of judo, and the perils of being a Glasgow boy who was actually born in (shhhh … England!) “You can imagine how that went down growing up in Glasgow – the fact that I was born in Consett. My father was the manager of the Consett Ironworks at the time, but my parents went back to Scotland when I was still a baby.” He might have been born here and lived in England a long time since, but there’s no doubt who this popular doctor sup- ports through the Six Nations. Dr Lockerbie has been in Dartmouth for 26 years. As one of seven partners in the Dartmouth Medical Practice, he is proud of the unique set up honed by the Dartmouth GPs. This is a portfolio practice where each of the GPs fulfils a different role and brings with them their own particular expertise. Graham is the chairman of the local GP Commissioning Consortium and handles Primary Care Trust matters, liaising constantly with the health service. Another example is Dr Andrew Eynon-Lewis, who works extensively on GP education and the training of medical students, Dr Adam Morris is an expert in cardiology and Dr Anthony Anderson in ear, nose and throat. There is also expertise in dermatology and rheumatology – skin and joints to those untrained med- ics amongst us The practice also employs a salaried doctor and a hard working team of nurses, health care assistants and re- ceptionists. It is a hive of activity where everyone has learned to expect the unexpected.


All of this work, the skill set, the management and liaison with other authorities, stands Dartmouth in good stead when it comes to the coalition Government’s plans for NHS reform. Dr Lockerbie is taking it all in his stride, but that’s not to say he doesn’t applaud the next step for GPs. “The Big Society could be good for us,” he said,


commenting on the Government plans to get rid of the Primary Care Trusts and pass control of budgets to GPs.


“The Big Society could be good for us,” he said, commenting on the Government plans to get rid of the Primary Care Trusts and pass control of budgets to GPs.


“I’ve been through five major health reorganisations since I’ve been here – Family Practioner Committees, GP Fundholding, Health Authorities, PCGs and PCTs, now we are to have Strategic Health Authorities. The only constant throughout has been General Practice, which is very interesting. While the nature of the job has changed, the principle that if you feel poorly you go and see your GP is still there. The health service is completely free at the point of contact. GPs are the gatekeepers for the NHS. I think the new reforms just make that more obvious.” News bulletins say GPs will hold the purse strings of the National Health Ser- vice, wielding new power. Dr Lockerbie said: “We will be making big decisions on funding public health.” Surely we’ve been here before? Back in the 1970s Barbara Castle called for a shift away from hospital treatment


“GPs are the


gatekeepers for the NHS. I think the new reforms just make that more obvious.”


towards more community based services. Throughout the 1980s and 90s the message was the same, but by now we had huge hospitals mopping up community health care. In the 1990s ministers gave GPs their own budgets (GP Fundholding) which was scrapped by the end of the decade, before practice-based commis- sioning was brought in by 2004. The ping pong has continued ever since. Is this latest move going to mean big changes? “This is not fund holding all over again,” Graham ex- plained. “Fund holding was limited in scope and GPs were only given 25 to 30 per cent of the budget to spend. It also wasn’t compulsory – this is. The change will start in a shadow form in April and kick in properly in 2013, when GPs become accountable for the money – long overdue in my opinion. “For the whole time I’ve been in Devon, acute hospitals have been the focus of


attention. There has been a steady increase in the number of consultants and the standard of care that they offer. They hoover up huge amounts of money, and the only way that we will be able to face the financial challenge of the next few years is to change the way we think and take some of the care delivered


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