Can we learn from history? Yes, and this is something to be proud of. But the need for change remains

16 July 2021

I’m delighted to announce our first online exhibition, 'Women at the heart of general practice', highlighting the journey from women first becoming doctors (a huge battle in itself) to being more than half of the medical school intake and GP workforce. Take a look: there are fascinating insights, and we hope it will trigger interesting reflections and conversations. The College is planning a series of events over the next six months to discuss its implications.

But equality is not just about numbers. The findings of the Dacre Report (6.28 MB PDF) show us that inequity based on sex remains - both in hospital and general practice. Even when age, hours worked, and roles held are taken into account, there appears to be a substantive gap between the average earning of female and male GPs. This also relates to ensuring that women get the same opportunities as male colleagues to develop their careers as GPs. There is some evidence that the continued 'double burden of caring' for dependents continues to fall more on women than men, reducing their working hours and sometimes slowing down career progression to more senior leadership roles.

Later this evening at 19:00, we will hold a webinar to examine the findings and possible solutions. As we have tried to emphasise in our work on equality, diversity and inclusivity across the RCGP, sex is one lens where unintended discrimination can occur, and where it is only conscious awareness and effort that has driven change.

Can we learn from history? Yes, and this is something to be proud of. But the need for change remains.

You can listen to AiT Committee Co-Chair Sophie Lumley and I discussing women in general practice on BBC Radio 4’s Woman’s Hour.

At this evening’s 'Mending the gender pay gap' webinar, described above, I will be joined by Hon Sec Dr Victoria Tzortziou-Brown, Professor Dame Jane Dacre and an expert panel. It can be watched live at 19:00 and will be available afterwards.

Post written by

Professor Amanda Howe, RCGP President

Amanda Howe qualified as MRCGP in 1983, has worked as a GP since 1984, and currently practices at Bowthorpe Surgery in Norwich. She is also Professor of Primary Care at the University of East Anglia. She has a wealth of experience within RCGP, where she has previously held the positions of Vice Chair of Professional Development and Honorary Secretary. She is a Board member of the East Anglia Faculty and was their Provost 2016-2019. She is also the immediate past President of WONCA - the World Organisation of Family Doctors - in which role she promoted the crucial role of GPs in running effective and efficient health systems.

Amanda has a substantive track record in educational innovation and research, and has led the GP teaching for the Norwich based MB BS since its inception. She is passionate about enhancing training opportunities for medical students and young doctors outside hospital settings to strengthen patient care in community settings. Her research interests include mental health, professionalism and resilience, and effective empowerment of patients and professionals in care, education and research. Her wish as President is to bring her experience to support members, and continue our learning together.

Latest updates from College Chair Martin Marshall

RCGP elections

Voting is now open for the election of President 2021-2023 and the election of six Nationally Elected Council Members 2021-2024.

Council members represent you, so this is your chance to shape the future strategic and policy direction of the College.

Please visit our elections microsite to cast your votes. Members will need to input their security codes in order to cast their votes.

Voting closes at 12 noon on Friday 30 July.

Lockdown easing

As we approach so-called 'Freedom Day' on Monday, general practice is braced for a steep upsurge in our already burgeoning workload. It won’t just be a case of more presentations of COVID-19 and other transmissible diseases, but potential cases of long-COVID too. I’ve written about the impact these long-term symptoms of COVID will have on patients, general practice and the wider NHS in The Times this morning.

The College is being vocal about the need for people to remain cautious as things start to open up, and we supported the Academy of Medical Royal Colleges in their calls for this last weekend. We’ve also commented on this for a number of media articles due to be published over the weekend. We were reassured to see that NHS England guidance urging the continued use of masks and appropriate social distancing measures in healthcare settings, including GP surgeries, will remain.

It's also been encouraging to hear a marked change in tone from our new Health Secretary Sajid Javid this week, after his initial comments about opening up when he took the role. It was good to hear him acknowledging the excellent work of GPs and our teams in the Commons during Health Questions on Tuesday.

Health and Care Bill debated in Parliament

MPs debated the proposed reforms outlined in the Health and Care Bill for the first time this week. Ahead of the debate, we briefed MPs on the College’s priorities for the Bill (348 KB PDF).

These include: ensuring a strong clinical primary care voice is represented in the reforms and beyond; addressing the NHS workforce crisis through implementing workforce planning; calling for further detail on the Bill's intention to extend powers of the Secretary of State, and improving the system beyond the legislation - health inequalities and patient participation.

Many of our priorities were reiterated by MPs from across the political spectrum. In particular, Conservative MP for Chipping Barnet, Theresa Villiers, echoed our calls for the Bill to ensure a strong GP voice, stating that "GPs are currently under unprecedented pressure. I urge the Minister to ensure that the Bill gives GPs a strong voice in the new structures to ensure that local input is given to those new structures".

You can watch the debate.

Registering undocumented patients

You might have seen some reports about GP practices not registering undocumented people, and the impact this has on their access to the COVID-19 vaccine, as well as other health services.

We don’t know the reasons for this, although in many cases it is likely due to a lack of information for practice staff on the rules. No patient needs to have proof of address or identity status to register with a GP practice and access our services. You can find out more via the Doctors of the World 'Safe Surgeries' campaign, which the College has endorsed.

It’s vital that patients are able to access GP services, particularly vulnerable patients such as undocumented people, refugees, asylum seekers and homeless people, Honorary Secretary Victoria Tzortziou-Brown responded to the Bureau of Investigative Journalism on this issue. You can read their full article and our full response.

Call for volunteers

The numbers of doctors working as locums in the NHS has doubled in recent years - many of them from black, Asian and other ethnic minorities. NHS organisations need the flexibility and capacity provided by locums, but there is little empirical evidence relating to locum practice and the best way to support them.

A team of researchers at the University of Manchester are conducting research to better understand the use of locums in the NHS. They are conducting interviews to understand the locum experience, and are particularly looking to recruit participants from black, Asian, and other ethnic minorities to take part in interviews.

If you are a locum and are interested in taking part in this research, you can email

Post written by

Professor Martin Marshall, Chair of RCGP Council

Professor Martin Marshall is Chair of the Royal College of General Practitioners and a GP in Newham, East London. He is also Professor of Healthcare Improvement at UCL in the Department of Primary Care and Population Health. Previously he was Programme Director for Population Health and Primary Care at UCLPartners (2014-2019), Director of Research & Development at the Health Foundation (2007-2012), Deputy Chief Medical Officer for England and Director General in the Department of Health (2006-2007), Professor of General Practice at the University of Manchester (2000-2006) and a Harkness Fellow in Healthcare Policy. 

He is a Fellow of the Royal College of Physicians of London and of the Faculty of Public Health Medicine and was a non-executive director of the Care Quality Commission until 2012. He has advised governments in Singapore, Egypt, Canada and New Zealand, has over 230 publications in the field of quality improvement and health service redesign and his primary academic interest is in maximising the impact of research on practice. In 2005 he was awarded a CBE in the Queen’s Birthday Honours for Services to Health Care. 

A co-founder and driving force of the Rethinking Medicine movement, Martin has a passionate commitment to the values of the NHS, patient care and ensuring the GP voice is central in a time of great change. When he’s not working, he likes being outside, preferably on a mountain or a coastal path with his wife Sue and their puppy. 

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