Harold Shipman was a remarkably popular GP. Older patients loved him to bits because of the interest he showed in them. A lot of relatives loved him too, and valued the time he spent with his patients and that he even bothered to sit with them when they were dying.
Is this true? I don’t know. It’s an account that’s entered modern folklore, anyway. I tell the story only to highlight that there can be a world of difference between a popular GP and a good GP – not in any way to downplay the horrific crimes of Shipman.
A really daft proposal from Health Minister Ben Bradshaw was covered in last week’s Guardian. New Labour was evidently determined to end 2008 as it started it – doing everything possible to damage and undermine the NHS. Ben says that he never goes on holiday without consulting Trip Advisor. Fine, that’s entirely up to Ben. Apparently, though, Ben thinks we need to give ‘consumers’ of healthcare access to a ‘Rate Your GP’ equivalent of Trip Advisor. The plan is to set up a national website where everyone can post their judgements of their GP’s competence and report on whether or not there is a ‘rude receptionist’.
This is really pretty silly. A moment’s consideration of the Shipman story does at least demonstrate that a GP being popular is not necessarily a good thing. A few moments more consideration flags up pretty quickly that a good GP will be willing to challenge patients on unhealthy lifestyles (smoking, obesity, alcohol and drug misuse and so on). You don’t necessarily get immediate Brownie points for popularity that way. A moment’s more thought and you realise that patients quite often want the antibiotic or ‘magic drug’ that will make them better – even when there isn’t a drug treatment that will improve their condition. A ‘popular’ GP will write the prescription. A ‘good’ GP will spend the time explaining why this isn’t an option. There’s a difference.
Ben also fails to understand that seeing your GP – when you might be in pain, scared, upset, and vulnerable – is not an experience that can be meaningfully compared with choosing a nice holiday. Most health workers are familiar with patients or clients who are very distressed, and who – not in any way maliciously – might direct that distress at the doctor, nurse, therapist or receptionist. And most health workers, whenever we possibly can, seek to support patients through their distress, listen to them, explain to them, and give them the very best care we’re able to. It probably isn’t going to build therapeutic relationships to set up a national website where we encourage people to slag off GPs, practice nurses and receptionists. And if the comments are anonymous – as Ben says they often will be – how does this help a health worker to talk through a problem with someone and try and sort out whatever’s gone wrong?
Ben might also want to check out the libel laws! The kind of site he envisages is very likely to leave whoever hosts it – presumably the Department of Health – open to legal challenge. Just in case you’re looking in, Ben, a quick guide to libel law is here.
When I first read the Guardian article I thought Ben was just being a daft wee boy. On reflection, I think it’s more sinister than that. The Government is on a mission to demonise GPs – probably because GPs have become the major barrier to the Government driving through its ghastly polyclinic/ ‘GP-led Health Centre’ agenda. The Government is committed to replacing our existing (and much-valued) family doctor service with reduced access to a primary care service provided by (and for) big business. There’s therefore a political motivation for New Labour’s obsessive hatred of GPs.
I’m very clear indeed what I want from my own GP. I don’t want my GP to spend her time trying to be popular. I want my GP to have strong clinical skills, to take me seriously and treat me with respect, and to explain complex issues in a way I can understand. And if I did have a problem with my GP, or any other health practitioner, I’d see someone different, and I’d use the existing complaints procedure if I thought it was warranted. A ‘Slag Off Your GP” website is simply not useful.
The bottom line, though, is this: a GP who tries to be popular is probably not going to be providing high quality health care. If Ben can drag himself away from planning his next holiday for a moment or two, he might want to think about this issue a little bit more carefully.