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GPs under pressure to put costs before patients

No compromise for patient-doctor relationship says RCGP chair

Jo Carlowe

Thursday, 20 October 2011

The unique relationship between GPs and their patients must never be compromised to cut costs.

That is the message from RCGP Chair Dr Clare Gerada in her opening speech to the fifth RCGP annual national conference in Liverpool today.

In an address to nearly 1500 GPs and health professionals, Dr Gerada warns that the profession is under pressure to “replace the language of caring with the language of the market” and that patients are not commodities to be bought and sold.

She urges GPs never to lose sight of why they entered the profession – to care for the patient as a person.

“In this brave new cost-driven, competitive, managed-care world, I worry about the effect that the language of marketing is having on our clinical relationships. It’s changing the precious relationship between clinician and patient into a crudely costed financial procedure, turning our patients into aliquots of costed tariffs, and GPs into financial managers of care,” she says.

While welcoming the role of GPs in commissioning, Dr Gerada said that the commissioning agenda must not sacrifice long-term benefits for patients in favour of short-term savings.

"People often tell me that GPs make good commissioners because of the population-focus we bring to care. After all as a profession we see 300 million patients per year. If anyone can be said to have their finger on the pulse of the nation, surely it’s us. It’s an argument I’ve supported for decades. But we must tread carefully in this brave new world and do everything in our power to make sure it’s the public’s pulse we have our fingers on… not the public’s purse!"

Citing the HMO experience in America, she warns against doctors being doubly compromised between the best interests of patients and the need to save money.

“It’s the government’s job to decide how much we invest in healthcare – and what services the NHS should provide. Governments should have ultimate responsibility for decisions about rationing healthcare, not GPs."

She concludes: "We all became doctors because we wanted to make a positive difference to people’s lives. It would be hard to devise a better and more inspiring way of achieving this than through the provision of excellent general practice care, within a universal health service. In times of austerity, we need to come together so that we can collaborate, cooperate and innovate… not compete against each other.”

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