The view of a sessional serial GP locum is voiced in The Guardian: ‘The NHS is chaotic and inefficient but it would be easy to fix’

Richard Fieldhouse in The Guardian 13th June 2014 opines: ‘The NHS is chaotic and inefficient but it would be easy to fix’

The chief executive of the National Association of Sessional GPs wants to end the professional isolation faced by locums

Describe your role in one sentence: I balance working as a freelance GP in several dozen different surgeries with supporting the professional interests of up to half the GP workforce who choose not to work as partners.

Why did you want to work in healthcare? Because humans are so fascinating, and when their highly complex mind or body goes wrong, it’s really good to work with them to unravel their unexpected complexity and help restore it. And GPs are people too, and since we’re not very good at looking after ourselves, I became interested in helping them look after their welfare too.

How do you want to see the sector change in the next five years? I want to end the professional isolation faced by salaried and GP locums. It’s not good for them, and it’s even worse for patients.

My proudest achievement at work was … in 2002 when I chaired a national working group of locum group leaders, where we jointly came up with the locum GP chambers concept.

The most difficult thing I’ve dealt with at work is … seeing a salaried GP bullied by the partners in her practice. It seems that when things get tough, people develop siege mentalities and can just turn on their colleagues, rather than working together to come up with creative solutions.

I think the Health and Social Care Act is … our chance for a better voice for patients and more locally responsive services. But there are ominous and confusing signs of top-down interference, with GPs being given too much responsibility without the necessary reciprocal control. This all leaves me wondering if CCGs are being set up to fail. It has got to be properly funded, and it has got to uphold all the original values of our NHS.

The people I work with are … all fully qualified GPs and represent about 40% of the GP workforce, but on the whole tend to be marginalised, unappreciated and in some cases blamed as bringing about the demise of general practice.

I do what I do because … general practice is the jewel in the NHS crown, yet as GPs we continually undermine it ourselves by only focusing on one particular model of providing care. We need to work together.

Sometimes people think that … by promoting the interests of sessional GPs I am bringing about the demise of general practice as we know it. Far from it. I see local groups of engaged, flexible GPs providing vital support, and indeed a boost, to the ever increasing demands on practices.

Right now I want to … get GP locums away from the mindset of being the underdog – working in a state of competitive enforced underperformance – and to work together in cooperative teams where the service we’re then able to provide is so much better than the sum of its parts.

At work I am always learning that … every problem has a solution. Just keep listening; engage with the problem, ask more and more questions. A solution will always emerge.

The one thing always on my mind at work is … how chaotic and inefficient so much of the NHS seems to be, and how easy it would be to fix it.

If I could go back 10 years and meet my former self I’d tell them … don’t worry, you’re doing the right thing.

If I could meet my future self I’d expect them to be … greyer but still happy, and still running. I hope.

What is the best part of your job? Sharing a joke with a patient. Despite what people may think, there’s rarely a situation where you can’t have a laugh together.

What is the worst part of your job? Struggling with arcane NHS IT. It’s self-inflicted industrial espionage priming ourselves for private takeover.

What makes you smile? When our kids tell me I make the best pizza in the world. I don’t; they just like pizza.

What keeps you awake at night? Restless legs, but only when I’ve been out running and haven’t drunk enough water. I can’t believe how much water I need to drink.

Dr Richard Fieldhouse is chief executive of the National Association of Sessional GPs

easy street

This entry was posted in Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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