Bob Bury: Motives of New Labour attack on GPs

IT'S one thing to read press stories about this government's formidable capacity for playing the media, it's quite another to feel the full force of Whitehall's spin apparatus directed against you.

You'll have noticed a flurry of reports suggesting that one of the main causes for the dire state of NHS finances is the drain placed upon them by overpaid doctors.

I know a few GPs, and it was them I had in mind when I wrote that slightly emotive first sentence. You can hardly open a newspaper without reading about the avaricious family doctors coining it at the public's expense.

You will hear how they turn up at their clinics for a couple of hours, take a few blood pressures and give some anti-smoking advice, then wheelbarrow the day's takings out to the Bentley and are back home in time for Neighbours.

Critics should remember that it was this Government which engineered the new GP contract to reward family doctors for achieving against a wide range of healthcare targets, and the family practitioners have done just that.

In fact, they have achieved far more than Patricia Hewitt's predecessors expected, but instead of rejoicing at their success, she is panicking and talking about putting a cap on GPs' earnings.

She forgets that GPs are self-employed, and that inflationary pressures, including wage increases for surgery staff and the new requirement to pay the employer's contribution to GP pensions, has already made a major dent in their post-contract take-home pay.

And it was the Government who told the GPs that they could drop their out-of-hours commitment if they would accept a 6,000 cut in their pay. Six thousand pounds a year – that was the value politicians placed on the excellent emergency service that our doctors (unlike those of almost any other country) had always provided.

And guess what? They found that commercial operators charged a lot more than that to provide an inferior service, so now they are having to go back to the GPs and beg them to take it on again. If they agree, I hope they demand the rate for the job (and anyone who has tried calling out a plumber in the middle of the night recently will know what that rate is likely to be).

If the Government under-estimated the amount of work that GPs were doing, they did exactly the same with the consultants.

Alan Milburn, the then Secretary of State for Health, paid lip service to independent surveys showing that, on the old contract, the average consultant worked 48 hours a week for the NHS despite only being paid for 37, and yet he boasted to his Parliamentary colleagues that he would screw more work out of consultants by imposing a 40-hour week for only a modest increase in pay.

As the Americans say, "do the maths". Milburn either couldn't do the fairly simple maths or didn't really believe that we worked so many hours.

Now to go back to that opening sentence. GPs have noticed that most of the media comment on the issue of their pay contains the same inaccurate figures – figures which can be traced back to misleading Whitehall Press releases.

They are beginning to think that they are the victims of a deliberate campaign of misinformation, culminating in Ms Hewitt's threat to renege on the pay deal.

But why would the Government want to undermine hardworking GPs in this way? Well, they might do it if they were softening up the public for an auction of GP services to the private sector, a process which has already started in some parts of the country.

It's the same in our hospitals. The involvement of the private sector in the provision of diagnostic and treatment services has gone far beyond the initial move to procure a bit of extra capacity here and there to help reduce waiting times.

The Primary Care Trusts are being forced by the Government to spend even more money with commercial providers, regardless of need, using resources which would previously have bought those same investigations from local NHS providers.

In Leeds, and across the country, money is being diverted away from the NHS and into the pockets of entrepreneurs, and because the commercial outfits will only deal with the cheap, simple (and, therefore, profitable) cases, this has serious implications not only for the finances of NHS providers, but also for their ability to train the next generation of doctors, nurses and other healthcare workers.

And to add insult to injury, private companies still get most of their money even if they don't perform the amount of work they are contracted for, and regardless of the quality of service they provide. So that's where the new NHS cash is going – down the commercial drain, and not just into doctors' pockets.

It's why there needs to be a fundamental review of how health is provided in the region so Yorkshire patients benefit from a health service that reflects their needs.

The only logical way to account for New Labour's behaviour is as part of a deliberate backdoor attempt to destabilise the NHS and privatise it piece by piece. And, of course, because in name at least they are a Labour Government, this is the only way they can dismantle the NHS without appearing to sell out their "socialist" principles.

Paranoid? Kafkaesque? Guilty as charged, but if anyone can come up with a better explanation for the current madness, I'd like to hear it.

The only logical way to account for New Labour's behaviour is as part of a deliberate backdoor attempt to destabilise the NHS and privatise it piece by piece.

Bob Bury is a consultant radiologist in Leeds.