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Leaving the HSE survey unfilled

15 Dec 2016

After putting the latest HSE survey of general practice straight in the bin, Dr Ruairi Hanley fears the information will be used to undermine and humiliate the specialty and will do nothing to address shortfalls in patient care

Over the past few years, I have applied a simple test when it comes to any form of voluntary engagement with the HSE. I look at what they want me to do and ask myself one question: is this likely to make my life better or worse?

About 99 per cent of the time the answer is ‘worse’ and I immediately refuse to cooperate. For example, I have never been part of any primary care team because I would prefer to spend my days treating sick people rather than talking about them at epic meetings with health service desk jockeys.

Therefore, when I recently received a letter from the HSE informing me of a new ‘My GP survey’, I implemented the Hanley protocol and fed the document swiftly into the shredder. Some colleagues may think this response unwarranted. Allow me to explain my reasoning.

Firstly, an enormous amount of data already exists about the working conditions of Irish GPs. The numbers holding GMS contracts, the savage FEMPI cutbacks and our worsening manpower crisis are all a matter of public record.

The fact that many young colleagues will only work in either South County Dublin or Australia is also well recognised but rarely acknowledged. This latest survey will not alter any of this.

However, as the HSE would undoubtedly point out, this exercise is mainly aimed at patients and the type of service they expect from us. And that brings me to the next point.

House call on demand
If we asked the public what they wanted, I suspect the answer in some cases would be a 24/7 GP service with house calls on demand. Many people would also feel entitled to antibiotics, sleeping tablets and referrals to higher specialists whenever they deem it necessary, usually after carrying out their own necessary research on Google.

For those who think I am cynical, I invite them to consider a recent piece of research conducted in the UK. Half of respondents to a poll of 2,021 British adults stated their belief that ‘their GP should always give them the prescription, treatment, or referral to a specialist they request’. I suspect in this country the figures would be broadly similar.

GP authority
Our job as doctors is to use our training to give people the advice and treatment they actually need, rather than always what they want. Of course, patients should (and indeed must) be involved in the decision-making process, but this does not warrant our specialty having its authority eradicated and expertise routinely ignored.

Nor can we allow every consultation to turn into a 30-minute debate while sick people sit in the waiting room.

Unfortunately, while it is easy to blame society for this culture of entitlement, we are in truth the authors of our own misfortune.

Right-on politically correct GPs were so eager to eliminate any hint of paternalism (possibly because it interfered with their middle-class guilt) that they have now driven us to the other end of the spectrum — a dynamic where we are merely following orders.

Under the circumstances, when our specialty has so little respect for itself, it is perhaps little wonder many of our consultant colleagues are now treating us as a glorified secretarial and phlebotomy service.

Returning to the HSE survey, there is one other major problem here. Inevitably, angry people with time on their hands and axes to grind with members of the medical profession will be disproportionately represented in the results. They always are. No doubt the bureaucrats will be lapping up these online tirades of abuse.

In summary, I fear the HSE will use the information gathered to undermine and humiliate our specialty. All the bleating of uber-cool GPs in the media will achieve nothing because the narrative will not be controlled by them.

To those who believe that collaboration with the HSE is the way forward, I say this: do you honestly think these people are our partners? Do you honestly think they are concerned about what happens to your practice? Do you honestly think they care about your patients, when most of the people looking at this survey have never treated a patient in their lives?

This is an organisation that presides over 300 deaths a year on trolleys, and 300 more due to a shortage of ICU beds. This is an organisation that awards jobs for life with gold-plated pensions to administrators with a proven record of failure. This is an organisation that a previous Minister for Health declared “unfit for purpose”, yet it continues to run the show.

If there is one thing I have learned in the past 16 years it is this: general practice in this country has been moderately successful because we doctors remain in control and not the HSE.

Colluding with them can only make things worse for our practices, our patients and our society. Will we never learn?

Happy Christmas!

I will conclude this week (and this year) by wishing our readers and all the team at IMT a very happy Christmas!

I would also like to thank all those who sent me comments and (occasionally) messages of support throughout 2016. This is enormously appreciated and never forgotten. Best wishes to you all.

The year ahead promises to be a dramatic one for our health service. We truly live in interesting times.

Until 2017 – farewell!

The post Leaving the HSE survey unfilled appeared first on Irish Medical Times.

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