‘Hissy fits’ and blatant bullying: Sajid Javid vs. the GPs

“Last week, a receptionist saved a patient’s life,” said Dr Berenice Langdon in The Independent. She gave him an immediate face-to-face appointment at my surgery: “I saw him and sent him to A&E urgently (any doctor would have done the same).” He was operated on later that day and survived.

The story makes an obvious point: “proper doctoring involves an examination”. Telephone consultations “are not as good”. Doctors know it; patients know it. Before the pandemic, about 80% of GP appointments were face-to-face. During lockdown, demand dropped radically, which was a relief for “some very stressed and overworked GPs”. But now, the proportion is still somewhere below 60%. This needs to change if we’re going to do our jobs properly.

So it’s great news, said the Daily Mail, that the Health Secretary, Sajid Javid, has thrown his weight behind the campaign for face-to-face appointments. Every patient in England, Javid says, should have the right to see their family doctor in person. He has offered a carrot–£250m in winter funding – and a stick: a threat to take over practices underperforming on this metric.

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Predictably, GP leaders have thrown a “hissy fit”. As well they might, said The Guardian. With “breathtaking cynicism”, Javid has taken a Daily Mail campaign and made it government policy. Calling for an immediate return to pre-Covid ways of working – and an end to social distancing in waiting rooms–is “irresponsible while the pandemic is still with us”.

His plan for league tables, so that practices offering too many remote appointments can be named and shamed, is a clear case of “bullying”. It “beggars belief” that the Government is turning on family doctors to distract from its own “long-term policy failures”. The real problem is that GPs are leaving the profession faster than they can be replaced.

“I share patients’ frustration,” said Dr Nishma Manek in The Guardian. As a GP, “I want to see them”. But by and large, the “blended model” – with telephone triage and some phone appointments – works effectively. And the bottom line is that we have no choice. The profession is “running on empty”. In England, there are 2,222 patients for each GP, one of the worst rates in Europe, and it’s getting worse still: it was 1,923 in 2015. Campaigns like this only make patients angrier, and doctors’ working lives more difficult.

At any rate, it’s now war between Javid and the GPs, said Isabel Hardman in The Spectator. Ironically, the Health Secretary failed to turn up to his own face-to-face appointment last week at the Royal College of GPs’ annual conference. He sent Chris Whitty instead, who gave a lukewarm endorsement of the policy, but suggested the issue had “got rather more heat than it needs”.

The British Medical Association, meanwhile, says that 93% of GPs in England see Javid’s plans as unacceptable. “Everyone’s backs are now up, and that means a lengthy and noisy fight.”