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Political meddling threatens general practice, warns GP leader

13 March 2009

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The leader of Scotland’s GPs yesterday (12 March 2009) accused the government of relying on “politically driven targets”, instead of “clinically driven, evidence-based policy”, and warned that this approach threatened to undermine the success of Scottish general practice.

Addressing the Annual Conference of Scottish Local Medical Committees (LMCs), Dr Dean Marshall (pictured), chairman of the British Medical Association’s (BMA) Scottish GPs Committee, spoke of the value of the Quality and Outcomes Framework (QOF) of the GP contract in improving patient care.

He said the QOF was one of the “great successes of the GP contract and was “envied throughout the world”.

However, he added: “But here, our politicians are so used to failure they don’t recognise success”.

Dr Marshall said the government’s consultations on the QOF in England would have ramifications for Scotland. He said: “We need to fight to protect QOF from political meddling and from those who seek to promote their own political interests. We need to keep the QOF public, transparent, clinically focused and, most of all, evidence based.”

Dr Marshall also called on the government to review its policy on extended hours access to general practice.

He asked: “Is this one-size-fits all approach to policy really improving access to patients who would have difficulty accessing appointments during the working day?

“So far, anecdotal evidence suggests that in urban areas, appointments are filled by those who could come during the day: the elderly, the unemployed, the long-term sick. While in rural areas, appointments are not taken up and GPs sit in empty buildings waiting for a ‘demand’ that doesn’t exist.

“For whatever reason, the government appears to be wedded to this policy. But has it been a good use of limited NHS resources? In these difficult financial times, is it really appropriate for us to be wasting resources on what is effectively a PR exercise?”

Dr Marshall said that it was now time for GPs to take the lead in developing policy and highlighted the current BMA-led consultation on the way ahead for general practice in Scotland.

He said: “I want GPs and other health professionals to tell us what they think. I want patients to tell us what they want. I am not sure that we can always reconcile the two but by raising the debate it will demonstrate clearly the reality of providing a comprehensive service within a limited budget.”

BMA Scotland