Dirty examination tables, consultation rooms without doors, life-saving vaccines allowed to go out of date. These are just some of the failings highlighted in Professor Steve Field’s early inspections of GP surgeries in England – the first systematic survey of the service – and they make for unsettling reading.
Whatever our personal experiences of GPs – and they are obviously extremely variable – it is a shame that the only evidence we have had to go on has been limited. Now we know the truth about this “gateway to the NHS” – that a third of them failed on one of 16 key standards of quality and safety.
Given that the initial 1,000 practices included a large number that were prioritised for inspection because there were prior concerns, this is not necessarily a reflection of the quality of all practices, but is a worrying indicator. Coming as it does soon after the discovery of failings by GPs in early diagnosis of cancer, this arm of the NHS too would seem ripe for treatment.
While only a small minority raised serious concerns, Professor Field is right to point out that such basic lapses should not be tolerated anywhere. It seems astonishing that his new regime is the first independent, national inspection programme for GPs that has ever been undertaken. Already it has shone a light on problems – often in isolated, small-scale practices manned by just one or two doctors – which should have been picked up by local monitors years ago. But Professor Field is also right to caution against “knocking our GPs”.
Many surgeries surveyed were found to be providing an excellent service, and even at those where failings were exposed, some elements of care were of a very high standard and patients more often than not declared themselves content with the care they received.
GPs are the vital front line of our NHS, providing 90 per cent of all patient contacts. The care they give must be held up to clear-eyed scrutiny. Where they fail they must be helped to improve, and supervised until things go right. But they also deserve our unstinting gratitude and support.