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Mission Impossible


Posted on 05 April 2012

mission_impossible.jpgThe Blameless Broadcasting Corporation, which doth protest too much, because it did take sides, by providing skimpy superficial coverage of the Health and Social Care Bill, have at last done something useful. An independent survey ordered by the corporation of over 800 doctors, which we have no reason to assume is not unrepresentative, unlike the GP monkey surveys, has found that only 12 percent of doctors believe GP led commissioning will lead to ‘patients seeing a noticeable improvement in their care’. More than half (55%) disagreed; the remaining third must have sore perineums, for they are still sitting on the fence, saying they don’t know one way or the other.

Despite the weaselly wording of the survey statement which provides more than a little wriggling room – the question asks not whether GP led commissioning will improve patient care, but whether the doctor agrees that patients will see a noticeable improvement, that is to say it asks only about doctors’ perceptions of patients’ perceptions, not actual quality of care – there is no escaping the finding that the majority of doctors surveyed appear, at the very least, not to believe that GP led commissioning will improve patient care.

Putting aside the niceties of whether disagreeing with statement A equates with agreeing with the opposite of statement A, this finding – assuming it is representative – places tens of thousands of NHS doctors in an extraordinary, not to say impossible position. The primary duty of doctors – the GMC is very clear on this – is to make the care of their patients their first concern. If it is true – and there is no good reason to suppose that for many it will not be true - that disagreeing that GP commissioning will improve care equates with agreeing that it will harm care, then, for tens of thousands of NHS doctors, their first concern must be to obstruct GP led commissioning. Not only do they have a mandate (the 55%), they have a primary moral and professional duty to do so. If that means civil disobedience, so be it: their over-riding professional and primary duty, neatly captured in the GMC’s guidance, is to make the care of their patients their first concern. Obedience to bad law comes second, a very poor second.

Dr No thinks this is mission impossible for the majority of doctors. Nor can he imagine for a moment that Stilton will get off his fence and remind doctors of their first duty. He predicts that there will be many more sore perineums over the months to come.

1 comment:

I am going to report the whole of the medical profession, including myself, to the GMC.


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