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Standing up for the true value of general practice

1 March 2007

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Mayur Lakhani
Chairman, RCGP

In the face of rapid change in the NHS, general practice is facing pressures, challenges and opportunities. The expecta­tions of general practice are changing from the point of view of patients, society and health professionals themselves. It is hardly surprising that we feel unsettled about the impact of these changes on our ability to deliver patient care.

General practice is a key element of all healthcare systems in Europe and is recognised by health service providers as being of ever-increasing importance. It is well-rated and contributes to an effective and efficient health system.

It is about time that the true value of general practice, and the contribution of GPs and their practice teams in holding the NHS together, was recognised.

I am deeply concerned that general practice appears to have become the easy target for other deep-seated and complex problems in the NHS. Yet our daily conversations with patients show high levels of patient satisfaction. Surveys show year-on-year improvements. Patients repeatedly tell us that general practice is the most successful and responsive part of the NHS.

GP practices have been the enduring feature of the NHS in endless reorganisations and have provided much-needed stability. More than 90% of healthcare problems are dealt with in primary care, with over a million consultations taking place on an average working day – but this is seldom acknowledged.

The reality of a health service without general practice is very disturbing – fragmentation of care provided by multiple providers and patients categorised according to their diseases.

Another of the hidden values of general practice is our role as a safety net for patients – the old, the vulnerable, people with complex and multiple diseases. We never discharge patients but carry on providing lifelong care for generations, yet most of this work goes largely unnoticed or is overlooked.

It is time to raise the level of debate and for decision-makers to start playing up the strengths of general practice. Policymakers must build on the values of general practice and avoid making decisions that run the risk of
fragmenting care.

I am proud of the work that we do, especially given the constraints under which practice teams operate. When people are sick, they want to go to the GP practice they know and where they are known.

No one is saying that everything is perfect or that there is no room for improvement, but we must never give in to the pessimists who say that general practice is somehow in decline.

Instead, we should be standing up for the thousands of health workers in general practice who are striving towards ever-higher standards of patient care and making a real difference to people’s lives on a daily basis.

Strong and creative practice management is the key to a secure future. A big “thank you” is due to practice managers, the unsung heroes of primary care.