RCGP Conference Grills Andrew Lansley

Came across this account reporting the Speech and questions session to Andrew Lansley at the RCGP annual conference in Liverpool:

The RCGP Grill Andrew Lansley

That’s what the headline should be. You won’t find it on the BBC news report, which reads like a cut and pasted soundbite from the DoH. I couldn’t see any sign of the incident on sky news, though we had been informed they were also invited. So for your information, inspiration and amusement, here’s an eyewitness account in black and white, if you care to read.

Today, Saturday the 22/10/2011 was the last day of the annual conference of the Royal College of GPs. The conference had been full of research, discussion and inspiration, centring on making general practice work for the benefit of all patients, particularly the poorest and those in vulnerable circumstances. It focused in on tackling inequalities and public health needs in sustainable and innovative ways. There had also been plenty of debate about the health and social care bill (currently at committee stage in the Lords), especially on the idea of GP commissioning. While the mood regarding the idea of GP commissioning was mixed, the resounding tone to the bill itself was a firm rejection.

Come the last day of the conference and the secretary of state was invited to speak. In recognition of the desire of delegates, effort was made to set aside additional time for questions afterwards. Of the 20 people asking these, only one had anything positive to say about this bill, all the rest were very clear in outlining their concerns and the reasons for those concerns, in dynamic and sometimes entertaining ways.

One particular highlight for me was the GP who asked for Mr Lansley’s definition of privatisation, on the basis that unclear definitions can really get a person into trouble, using Bill Clinton’s definition of not having sex with Monica Lewinski as an example. The question was answered (eventually, with much pressing) that he means healthcare being free at point of provision, but DID NOT exclude in any sense private companies and corporations competing with public services to provide care. The forthright response from the chair of the RCGP, Clare Gerada, was that this is not the manner in which any of the GPs present were using it & certainly not the definition usually used in literature of healthcare.

One key theme behind the grilling was that “choice” in the form of competition for healthcare provision, and the introduction of markets into healthcare, have been shown repeatedly to be more (not less) costly, associated with poorer health outcomes, and particularly bad at tackling healthcare inequalities. The questions reiterated that not only is there evidence that structural change is not required, but that the specific change proposed would break that line of the Hippocratic oath, “first, do no harm.” Poignantly, one GP took the words from his own speech as her inspiration, “You have told us that where we see wrong, we should say something and do something about it; well this bill is wrong. So I would like everyone in this room, who agrees that it is wrong, to raise their hands.” A sea of hands was raised, mirroring the results of a survey of all members of the college.

After the speech, the president of the college, Iona Heath, made her closing address, which afforded her the opportunity to complete a quote, only partially quoted by Mr Lansley in his speech, “it’s interesting what gets edited out”. It is from a paper which appeared in the peer reviewed journal, The Lancet, in 1971, written by JT Hart, and I can do no better than quote it here, “The availability of good medical care tends to vary inversely with the need for it in the population served. This inverse care law operates more completely where medical care is most exposed to market forces, and less so where such exposure is reduced. The market distribution of medical care is a primitive and historically outdated social form, and any return to it would further exaggerate the maldistribution of medical resources.”

But I have misled you; I promised entertainment as well as information & inspiration, so I shall leave you with two closing snapshots. One of a GP with welsh wit, asking whether the secretary of state would be as happy meeting with and listening to the purveyors of cannabis and ecstasy, as he was with the alcohol industry leaders, given that drug’s greater associated morbidity and mortality. And a final one, Mr Lansley, attempting to justify the reasoning behind obliterating practice boundaries (and therefore as the patient representative pointed out, removing the clear lines of responsibility for care for patients that are sometimes deemed, difficult, and are often with great healthcare needs), explains that in these mobile times, many people do essentially live in two places. “You mean, have second homes?” quipped Clare Gerada.

Also found this link to the inaugaral speech by Clare Gerada: http://www.gponline.com/News/article/1099879/Video-exclusive-RCGP-chairwomans-full-speech/

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