The future of General Practice - Lord Darzi & Dr Peter Smith

Dr Peter Smith OBE is prospering

A email arrives from a GP in Kingston (upon Thames, that is). She is worried about Dr Peter “did you hear I got an OBE” Smith. We first met him awhile ago when we were discussing his role as President of the National Association of Primary Care. In “The Akond of Swat and the NAPC” a shamefaced Doctor Crippen had to admit that not only did he not know what the NAPC did, he had not even heard of them. It was a relief to find that they were “shaping the future of primary care”. Really, it says so on their logo, so they must be.

Dr Peter Smith OBE (third from left)

Dr Crippen has always admired entrepreneurs and was delighted to hear that a leader of British GPs like Peter Smith, as well as being a GP in Kingston, as well as being President of the NAPC, has been able to find time to be the director of Primary Care for United Health UK. There was a prominent advertorial for United Health UK in the BMJ two weeks ago, featuring an even more prominent picture of Peter Smith. He has grown into the job.

Dr Peter Smith OBE

The company’s UK plans are to use its expertise to manage primary care services in areas of high deprivation, where Pete Smith, its primary care director and also a partner in an NHS PMS (personal medical services) practice in Kingston, believes it can “make a significant difference.” To date the company has taken over two GP practices in Derby and has just been awarded three practices in Camden. (BMJ)

Dr Smith said that

being a good employer is key to attracting, motivating, and keeping staff. He says the company expects to honour the terms and conditions set out in the salaried model contract and has set up its own pension scheme with Prudential, which he believes is “comparable to the NHS scheme.” The company pays on “the upper end of the recommended pay scale”. (BMJ)

Excellent. This is the way forward. This is the future of general practice. Of course, the lazy, avaricious incompetent local GPs who were caring for the patients before United Health arrived are angry because they cannot cope with competition. The doctor’s comic, PULSE, was on its high horse again:

US giant UnitedHealth, became the latest private firm to defeat local GPs in the running for an APMS tender, sparking fury among doctors. One of the practices has been run for the past six months by four local GPs, who bid for the tender but lost out. They claim the decision by Camden PCT came down to cost. (Pulse)

Of course it came down to cost. That is how tenders work, you idiots. United Health and Dr Smith beat you hands down. Stop whinging.

The contract for United Health Europe is its first with a London health trust. It gives the group, the largest healthcare corporation in the US, control of the Brunswick Medical Centre, King's Cross Road Practice and Camden Road Practice, Camden. Doctors claim that it will mean the end of traditional practice and " personalised" care. But private firms argue they will open longer and offer more health checks than traditional surgeries. Dr Richard Halvorsen, who lost out on the contract to United Health, said he was offering to spend £100 per patient while it was spending £75. He said: "This is another example of a cut-price privatised service being imposed on patients against their will. I fear that patients will suffer as a result." He added that patients will be disrupted by an influx of new doctors and will have to become accustomed to new systems. Under plans unveiled by health minister Lord Darzi, more private companies will be given contracts to run NHS surgeries. They are being invited to bid for 100 new GP practices and 150 health centres nationwide. (Evening Standard)

Halverson is the sort of uncaring spendthrift who is bringing the NHS to its knees. Why spend £100 per patient when Dr Smith and his team can do the job for £75? It is taxpayers’ money, you know. I was horrified to see today that even Private Eye is getting the boot in.


In "Heebie-GPs" Private Eye says that a locum doctor who had been working at the Camden Road surgery for 18 years was not kept in post by United Health and was only reinstated after an outcry from patients. But only for three months. And she is not being paid by United Health. She is being paid directly by Camden PCT.

“This means United can make even more profit as it has the doctors services for free” (Private Eye)

Clearly, Private Eye does not understand basic business principles and does not understand the profit motive. Locums, by definition, work on temporary contracts. Dr Smith says, “being a good employer is key to attracting, motivating, and keeping staff” but you cannot expect that to apply to locums. They are temporary staff not permanent employees. And remember, United Health UK is going to improve healthcare in the UK. They tell us that on their web-site

United Health UK

Look at United Heath situations vacant site. They are already advertising two positions in Camden. Both for nurses:

Clinical Responsiblities include :

• Assess, diagnose and treat any patients presenting to the Nurse Practitioner on a day to day basis, seeking colleague assistance or referring to an appropriate specialty as necessary.
  
• Provide an holistic approach to healthcare, drawing from both the nursing and medical model of health and illness where appropriate in order to screen for the early signs of disease and diagnose acute problems.
  
• As required, monitor and triage by telephone all home visit requests... (United Health : situations vacant Camden)
  

They are not advertising for any doctors. Which means they do not need any more doctors. As the blesséd Fradd the Destroyer has told us many times, you can employ several nurses for the cost of one doctor and, frankly, if nurses can “assess, diagnoses and treat any patient” who needs doctors?

This is where Dr Peter Smith OBE and Lord Darzi are taking us. This will save the NHS. And, my friends, I have had a small glimpse of future.

Arise, Sir Peter Smith.