To Boldly Go....
My first duty as chairman must
be to pay a warm tribute to my predecessor, Dr Jeni McAughey.
Jeni’s dedication, enthusiasm and common sens have ensured that her
period of chairmanship was a very successful time for the college
here in Northern Ireland.
I consider it a privilege to
have been asked to chair the RCGP NI Council, particularly at a
time of historic change in our Province when I believe there is
room for optimism and hope.
GPs are delivering and
demonstrating high quality evidence-based care and government
surveys confirm this, however the profession appears to be under
unprecedented attack. It would certainly be easy to become
despondent and demoralised. Perhaps we need to get things in
perspective.
Let’s start by looking at
yesterday. Many of you will be familiar with primary care 1950s
style as exemplified by TV’s Dr Finlay. The GP, his housekeeper and
a single district nurse provided comprehensive care to the entire
community. They dealt with all manner of problems and rarely if
ever referred to the hospital; even when they did it was a
community hospital which they ran themselves anyway. It makes me
feel rather inadequate.
The GP of tomorrow doesn’t make
me feel any better - Dr Bones Mc Coy from Startrek manages to cope
with everything including “Life but not as we know it”. I think I
could definitely do with him in Cullybackey! Perhaps the only thing
we do better than him is home visits as he simply beams everyone up
to the Enterprise! So, what about today? Across the profession one
increasingly hears comments like, “demand is high and rising”, and
“there aren’t enough hours in the day”. It seems clear that more of
the same is simply not sustainable. We need to be pragmatic about
what is achievable and acknowledge that there are different
perspectives. Patients want easy access to high quality services,
clinicians want to provide effective services in a safe way,
managers want to organise services in an efficient way and
Politicians want votes!
A number of encounters have
informed my view of General Practice over the last couple of
months. I was contacted by a former medical student who had been
attached to our practice several years ago. She told me that until
her attachment she was unsure about what career path she might
take; she had found her time in general practice both exciting and
inspiring and she had decided to become a GP. Recently I have also
been involved with the formation and launch of the RCGPNI Patient
in Practice or PIP group, a voluntary group which involves
considerable effort from our lay representatives for no financial
reward. The level of interest in the group and the caliber and
enthusiasm of the appointed members was humbling. Finally, I
attended the funeral of a young patient who had died of a tumour. I
wrote the referral letter when he first presented with significant
symptoms, and four years later I wrote his death certificate.
Although he saw many tremendous and dedicated professionals and
specialists, I know that in the end he and his family valued the
continuity of care provided by a local practice.
General practice is greatly
valued by the public and by our patients and as a profession we
need to be confident about what we do. General Practice is changing
and will continue to change. I believe that as GPs we need to
identify the problems, plan, integrate and manage our resources,
and throughout the process communicate effectively and build
partnerships. So can we do all this? I believe we have started.
Every town and village has a local practice which patients relate
to. GPs might be seen by some as the grumpy old men and women of
the health service who either say no or ask how much it costs but
the reality is that when the time comes they rise to the challenge
and deliver. The primary care team is much more integrated and
effective than ever before.
This is clearly demonstrated by
the awards presented at the recent RCGP Celebration Evening.
Practices in Northern Ireland are extremely motivated and have
responded to the new GMS contract. Most are scoring very highly in
the Quality and Outcomes framework. So I hope we can see that the
existing general practice infrastructure and personnel offer
untapped potential. As we consider the future if we are to fully
realize that potential we need to develop synergistic
partnerships:
- Partnerships with
professionals
- Partnerships with
patients
- Partnerships with
politicians
If we manage to accomplish
this, then we will have done a great deal to achieve the much
talked about primary care-centred NHS which will ensure, as another
famous doctor once said, that we all: “Live long and Prosper.”
