Taking a forward view
I
N NOVEMBER of this year Professor Maureen Baker will step down aſter three testing years as Chair of the Royal
College of General Practitioners, making way for her successor Dr Helen Stokes-Lampard. Professor Baker worked for over 15 years
as a GP in Lincoln and was Honorary Secretary of the RCGP from 1999 to 2009. In 2007 she joined NHS Connecting for Health (CfH) and was Clinical Director for Patient Safety at the Health and Social Care Information Centre. She has also held appointments with the National Patient Safety Agency, NHS Direct and the University of Nottingham. She is originally from Scotland and
studied medicine at the University of Dundee.
How have we come to the current state of “crisis” in general practice? I do think it’s largely because of the consistent, repeated underfunding of the service over the last 10 years. Tere have been a variety of reasons for this. Tere was an abreaction following the 2004 contract where the press kept going on about GP pay and how GPs had done too well out of that – which in no way justifies not investing in the service adequately. Also I think there has always been this short- term reaction to the part of the system that makes the most noise. Generally over the last 10 years that’s been the acute sector. Pressure on the acute sector becomes very visible with pictures of ambulances queuing outside A&E departments and patients made to wait many hours. What was happening in general practice wasn’t hitting the headlines; so it wasn’t picked up and addressed.
Do you think NHS England is on the right track with its General Practice Forward View? Yes. I do. I think it’s a hugely ambitious
10
Summons speaks with Professor Maureen Baker about the challenges facing general practice and the highlights and frustrations of her time as Chair of the RCGP
statement of confidence in the service of general practice and we were very pleased to welcome it. Is it enough? Well I hope so. I certainly hope it is enough to turn around the fortunes of general practice and the profession, and to be able to build on from there. I do think the direction is absolutely right in terms of addressing the fundamental issues of funding, workforce and workload.
Do you think there should be an equivalent GP Forward View in Scotland? I think there should be a plan to address these three key issues in every nation of the UK.
What do you think is the highest priority for the NHS in addressing recruitment in general practice? In England, I think the GP Workforce 10 Point Plan set us off in the right direction – looking to see what is working and how we can build on that. For instance, the financial incentives to recruit trainees into under-doctored areas: initial impressions suggest that this is having an effect. So if that works it might be extended. Recruitment roadshows are also important: spreading a positive message about general practice and helping to dispel some of the myths. In his foreword to the GP Forward View, Simon Stevens writes: “Tere is arguably no more important job in modern Britain than that of the family doctor”. Now
that’s a hugely powerful statement coming from the head of the NHS. So I don’t think it’s any one initiative: it’s putting them all together and applying them at the same time. Te aggregation of marginal gains – the Team GB Cycling approach – is what we need to bolster the workforce.
Could the rise of primary care specialties help encourage more doctors into general practice? For me there is something very important about the expertise of the generalist. We talk about GPs as the expert medical generalist – the last bastion of clinical medicine. Where else in medicine are you making decisions based on your clinical skills, the patient history, doing something there and then without a panoply of other colleagues or the ability to get instant investigations? But generalists, almost by definition, have a wide range of interests. Terefore it is not at all surprising that people might like doing some of the things they learned in hospital and applying those in the community setting. For many people it’s an added attraction. So, for example, people who like doing minor surgery can do that in general practice.
Considering the talk around mass resignations how can the government best retain the GPs it does have working in the NHS? Again, by addressing the fundamental issues of funding, workload and workforce. It has to be an enjoyable, worthwhile job and if it doesn’t feel like that, people won’t stay.
Do you think that GP induction and refresher schemes could be improved to boost GP numbers? Tey are much better than they were. But the one in England, which I’m most familiar with, still has a huge number of hoops to be jumped through. It’s not very
SUMMONS
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24