It’s the tinkering, the endless bloody tinkering, with institutions and services so fundamental to our collective wellbeing that, to put it bluntly: does one’s head in. From education to the NHS, via immigration and pensions, we don’t know where we are, let alone where we are going, because we are lumbered with perennial government by opinion poll, without vision.
The result is endless chopping and changing, leaving the public to play catch up. One small example, the AS Levels my elder daughter just sat through in May, the younger one won’t be sitting next May. We are going back to the system of final exam A-Levels only - years after it was discredited.
But this weekend’s tinker, fiddle, bumble and fudge is to do with GPs; changing yet again how GP practices are viewed, measured and ultimately funded.
The new genius idea is to put failing GP Practices into “special measures”. From this October, 8,000 NHS GP practices will be rated on the basis of whether they are “outstanding, good, requires improvement or inadequate”. Well, it’s worked so well with schools, hasn’t it?
According to the Care Quality Commission: “Practices that fail to make improvements will be put into special measures, after which they will be given a further six months to meet the standards we require. At the end of their period in special measures, if we still judge them to be inadequate, we will cancel their CQC registration and their contract with NHS England will be terminated. In some cases, when we believe poor care is putting patients at risk or that a practice is not capable of improving on its own, we will put the practice straight into special measures.”
I know and you know that this means we are one small step away from the dreaded, iniquitous league tables that so blight our state schools. Those in charge of running the NHS seem to actually believe this is what we want, when what we really want is so blindingly simple.
When I was little we had a GP called Dr Morris. He was a kindly yet forbidding man, with a cold stethoscope and a succession of posh Rovers – I can still recall a 3500 and a 2000. The latter was butterscotch coloured.
How can I remember that? Because we visited that same surgery to see that same GP all the way through my Croydon childhood. One or other of those cars would be parked outside our house, perhaps once a year, on an emergency home visit – although looking back, there were only a couple of real emergencies.
That is what we want: a named GP we get to see within a day of needing to. Failing that, a group of GPs in a practice that we develop a sense of continuity and understanding with, and who are able to give us more that ten minutes’ time. We know they can’t currently and don’t blame them. It is clearly not their fault.
Talk to virtually any GP and that is what they want too. They hate the conveyor belt nature that endless cuts, re-organisations and streamlinings have foisted upon them. They want to give us the same exemplary care Dr Morris provided so selflessly and unfailingly that I can remember it to this day. Will special measures help achieve that? Will they, my a**e.