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"Are there 1,700 doctors in the House?"

Royal College of GPs conference - plenary session1,700 doctors in Liverpool Conference

Thanks to the kindness of the Royal College of General Practitioners, Peter Bates was able to attend their national conference "Diversity in Practice" at the Liverpool Arena in September on behalf of MDF.

MDF has a general interest in making health services accessible to disabled people. We know there is still a long way to go on that - as some of the doctors' own conference presentations suggested. But there are two specific areas where we need to make sure that we are closely involved with what is going on in GP circles, - on behalf of the groups that we represent.

  • One of these has been an issue for a long time - getting GPs to link their patients to VCS groups for advice and support. (Something that other groups in Liverpool are also taking a close interest in ).
  • The other is a more recent issue - how VCF groups can get involved with the new NHS commissioning arrangements, arrangements that will put GPs (and, in the updated version, other medical professionals) in change of buying health and services.

The short (if not very helpful) answer from the conference is that the problems that we face in both these areas are not unique to MDF to Merseyside

Involving GPs with VCF

A number of national voluntary groups that were exhibiting at the conference said that they also had problems in getting GPs to systematically make use of their services and information. They confirmed what we have seen in other research, and anecdotes from groups and from GPs. GPs are busy people faced with many campaigns and conflicting demands on their time. Working with a changing voluntary sector which has unknown - and variable - levels of quality and competence is not always a high priority.

We made connections with a number of projects that are providing information to GPs - for example incorporating voluntary group information into the existing computerised systems that already help GPs with clinical referrals to hospitals or specialists.

Royal College of GPs conference - notice board where GPs have recorded lack of confidence in commissioning for disabled people The display for the national disability charity Livability had a crude interactive system for doctors (photograph on the right) which seemed to show what we all suspected - GPs need help when they get involved with issues of disability.

Commissioning changes in the NHS

Many GPs present were only reluctantly beginning to accept that they would be involved in commissioning services. Some were passionately against the changes, which they saw as fundamental disruption to the way the NHS works:

  • 'I want to say “I save a life” not “I met a budget” '.
  • GPs should have their fingers “on the pulse of the nation – not its purse”.
  • Big decisions (like rationing health or closing down hospitals) should be responsibility of politicians not doctors.
  • The much-praised “US model” of health care is in fact one of unnecessary treatments, and which promotes a basic health inequality which leads to many unnecessary deaths.

A number of speakers in formal presentation sessions and debates were promoting the advantages of a "generalist" approach, which emphasises a continuity of doctor-patient relationship. This is valuable to health and well-being but not always understood by funders or some managers, who may want to see patients to move between various specialists professionals..

This generalist approach was seen as key for people with more than one condition - and that is something increasingly likely as there are more and more older people in the population. The “10-minute consultation must go“, because conditions - such as mental health issues - are difficult to pick up if GP time is strictly budgeted.

There was still a great deal of detail to be sorted out (the Health Bill has still not been passed) and when the changes do happen there may well be a chance to get the voluntary sectors' voice heard but groups need to keep up with changes in their area and make local contacts as soon as possible.