"Don't knock GP's. We do our best on limited funds"

Here's an interesting letter submitted to the Daily Mail. Dr Kailash Chand talks all things general practice.

"GP bashing should stop. No doubt there’s a variation in standards of primary care, which needs addressing, but the primary care model in the UK is the best way to deliver care to the public. Look at general practice in Europe and beyond. In Holland, GPs spend longer with patients- 20 minute consultations are normal. In Spain, whole aspects of clinical care aren’t done by GPs at all; all smears are done by gynaecologists.

In Hungary and the Czech Republic, all children are seen by paediatricians. In most of Europe, patients see specialists freely, without reference to their GPs. In Sweden, out of hours services begin at 5pm and between midnight and morning there’s no primary care; patients either attend A&E or call an ambulance.

Throughout Europe, no nation operates targets or makes systematic data entry, no measurement of practice performance of chronic diseases as we do.

And there’s little revalidation of doctors like our GMC scheme, under which doctors have to justify continuing clinical practice. Even continuing medical education is voluntary in Spain, Portugal, France and Luxembourg. Canada has no registered lists, only 30 per cent of practices are computerised and there’s no measurement of immunisation or cytology.

In Britain, every patient who wants to see a specialist must see their GP first. We, not the specialists,
manage 90 per cent of patient care, as well as continuing transfer of work from hospitals. We provide the entire spectrum of clinical care, from baby check- ups to the elderly, managing chronic conditions such as diabetes, epilepsy, heart disease, and even renal disease, which would be alien to GPs in other countries.

And we do all this with fewer GPs per head than most of Europe. When the system fails anywhere, it’s us patients turn to. To do all this, we’re paid just £70 per patient, a fixed amount for an unlimited number of consultations or visits per year. Funding of general practice in England has slumped to just 8.5 per cent of the total NHS budget.

Instead of naming and shaming GPs, we should be campaigning for more investment in training, education and funding of primary care."

Dr Kailash Chand OBE