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- Page navigation anchor for Jottings of an Old FELLAJottings of an Old FELLAFrom time immemorial general practice has been the sump of the medical profession. In the early days of the NHS most negotiations centred round consultants rather than general practitioners. This is hardly surprising bearing in mind that those in general practice had neither training nor standards to which they could aspire.Many GPs entered practice because their relatives had been GPs or they had fallen off the specialist ladder, and this was so in my case. However, in 1963 I joined the then College of General Practitioners who seemed keen on promoting research and education specifically for those intending to make a life-long commitment.I found myself being involved in a series of modules under the auspices of the Nuffield Trust, which prepared us for teaching and eventually my Regional Adviser put my name forward to start a training scheme for Portsmouth and the Isle of Wight. We had joined the College without any form of examination and I found myself, having been appointed a Fellow and an Examiner in one month, having to take the exam and nearly failing it.Since then the College has grown in membership numbers but I am not sure in stature, and this I believe is due to general practice loosing its independent contractor status which was the one thing we prized above anything else. I believe that the loss of status is an explanation of the diminishing numbers of doc...Show MoreCompeting Interests: None declared.
- Page navigation anchor for RE: The Future NHS - time for another change?RE: The Future NHS - time for another change?
How I agree with Roger Jones' insightful editorial. The NHS has experienced an artificial (but nonetheless increasing) divide between primary and secondary care for nearly quarter of a century now. A parlance has evolved which incorporates concepts such as "spend" "provider" and "activity". It is regrettable that a whole generation of young medical and nursing staff don't know any different.
Prior to leaving general practice a year ago I crossed the primary/secondary care divide for a day a week working as a GP with special interest in acute medicine. It was soon apparent that not only did staff in emergency departments speak negatively about "the GP" or "the community" but neither had they the slightest idea what went on outside their establishment. Surprisingly perhaps the converse was also true - hospital practice has changed out of all proportion since many of us were juniors.
I still believe that being a GP is a wonderful career and things can only go upwards. However it is no coincidence that the commonest question I was asked by junior hospital doctor colleagues and those that I trained was how to become a GPwSI in acute medicine.
Competing Interests: None declared.