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Top GP quits over online posts

Dr Arvin Madan 'pleased' to see small GP practices close

Mark Gould

Monday, 06 August 2018

Dr Arvin Madan, NHS England's director of primary care, has resigned after it was revealed that he posted anonymous comments on a medical forum. Dr Madan, who has been a GP for 23 years and works in East London, posted on Pulse's website under the pseudonym "Devil's Advocate".

Pulse reported on Wednesday that Dr Madan stood by comments he made online suggesting GPs should be "pleased" with the closure of some small GP surgeries. In the comment he said: "There are too many small practices struggling to do everything patients now want for their families in a modern era of general practice". In the same magazine, the group GP Survival - which represents 8,000 GPs - had written an open letter calling for Dr Madan to resign as director of primary care.

Another post by "Devil's Advocate” said of GPs' pay: "We can get six figure salaries for working four days a week 45 weeks a year without on call... run that past the general public and see how much sympathy you get."

Dr Madan is one of the GP partners of the Hurly Group which runs 13 practices in 10 London Boroughs with 100,000 registered patients and 350,000 minor illness and injury cases from nine locations.

The British Medical Association (BMA) has written to NHS England chief executive Simon Stevens expressing its concern at the comments. The BMA's GP committee deputy chair Dr Mark Sanford-Wood said Dr Madan had "done the right thing and offered his resignation".

And Dr Chaand Nagpaul the BMA council chair said: “Doctors from all branches of practice support our colleagues in general practice and their central role as a fundamental part of delivering NHS care to patients despite escalating workload and inadequate resources.

“NHS England must now make clear that it values and fully supports all practices - unequivocally, the vital role of smaller practices - and demonstrate its commitment to all GPs in these testing times for the profession.”

In his letter of resignation Dr Madan said it was clear he had "lost the confidence” of some of his colleagues, and therefore decided to resign his NHS England position.

However, he defended the anonymous posts saying they were attempts to "challenge the negative views – and even conspiracy theories – held by a small but vocal minority in the profession I posted on an anonymous online forum used by GPs. It was never my intention to cause offence but rather to provoke a more balanced discussion about contentious issues acting as a devil’s advocate".

And he said he wanted to make it "categorically clear" that these comments are not a reflection of NHS England policy.

"I would like to apologise unreservedly to those who have been upset, particularly in smaller practices. In my 23-year career as a frontline GP I have worked in practices of all sizes and have always believed that smaller practices serve a particularly crucial role. I know they work tirelessly, alongside all primary care colleagues, to serve their patients and perform a role that goes well beyond being their doctor. GPs in smaller practices serve a particularly vital role as a point of constancy in the lives of often very vulnerable patients."

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