DF > And the contract, the appraisals crap, the revalidation
> stuff, all that reduces patient contact time.>>
AKM <appraisals and revalidation are one, or two (according to who you
listen to)
separate issues form the contract, are they not?>
I said <<At a time when direct clinical care needs
more GP time than before, it is not wise to divert GPs away from patient
contact. And the contract, the appraisals crap, the revalidation stuff, all
that reduces patient contact time.>>
What I actually intended to say was that appraisal and revalidation _also_
reduce patient contact time. I lump all three together because I see all
three as systems imposed from above, systems which are likely to make things
in NHS GP worse rather than better.
But let us expand the discussion a wee bit, as Adrian says
<<There wasn't any doubt those would be in under the previous contract or
any
other contract. So they and the time they take and their value are
orthogonal to the contract and its negotiation and effects.>>
I have my doubts about their inevitability. I see the power of the
profession in Canada where, for example, docs in Quebec disagreed with
certain ministerial plans and met en masse for a "study day". The
politicians came to heel very quickly when they heard that further "study
days" were planned. I think there was a semi-deliberate process of softening
up of GPs here in the UK, using firstly the appraisal/reaccreditation move
(which was, you recall, heavily supported by the College back in the 90s and
therefore had the gloss of academic approval about it) which was given wings
by Shipman et al, then the "contract" "negotiations" with the almost
inevitable seduction of our boys by the proximity to powerful pols on the
make followed by more appraisal moves with the thread of
what-will-the-GMC-do-next woven into the whole fabric. And no, I don't
really believe in conspiracies. But I do believe that powerful people desire
power and will try to damage other groups which threaten their hold on
power. GPs are mavericks and a major threat to pols of whatever shade so all
parties will try to reduce the power of GPs.
Declan
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