Medical musings: GPs should be the orchestra

I thank Dr Mummery for writing this article¹ and I hope it is taken on board by those who are driving the changes in primary care. May I though reflect that one unspoken concern is that nobody polices primary care as we are independent contractors, and whether a practice provides extra services (for example, ear syringing) or works more sessions for its income is not checked.

In the past the family practitioner committee was feared as it had power and sanctions. With the recent bad publicity about access and the numbers of face-to-face consultations, Dr Mummery’s comments about being on primary care network (PCN) committees versus seeing patients and offering continuity are so pertinent.

There is no dispute that demand greatly exceeds capacity in the whole of the NHS, but we have just had a local medical committee (LMC) vote to reduce the working day to 9 to 5 without any loss of income.

Could GP funding be rearranged so that instead of paying for pointless and often dangerous targets (HBa1 in older patients as an example), they paid a huge dividend for continuity and access?

GP partnerships have in the main always responded well to funding-related work.

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