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Reply to DoH responses to my concerns (and those of 850 others) over “naming and shaming” headlines

Dear Lindsey

Thank you for taking the trouble to cut and paste a response to the letter signed by 850 people expressing concerns about the “naming and shaming” headlines regarding delays in in cancer diagnoses, reported in a couple of newspapers on the 29th June 2014.

If you check email reference DE00000870296 to myself (alternative email address) you will find the body is identical to the response that you sent me on 18th July (ref: DE00000872042). I would have thought the fact that nearly a thousand people signed the letter may have led to a more considered response. I guess I was wrong. I find that insulting and patronising.

If Mr Hunt doesn’t believe in “naming and shaming” then why are details of a health policy that is yet to be finalised being leaked to media outlets with an anti-GP agenda? It matters not what is in the detail of such a policy when he knows that it will be spun a certain way. The fact that such leaks occur means that GPs cannot trust the collection of sensitive data as proposed.

Setting aside the impracticalities and costs of collecting data on suspected practicalities as well as the impact that this may have on referral rates and  consequently workload in secondary care (a fact that you have not acknowledged, I notice), I do feel that it may be better to discuss such policies with GP organisations and leaders. Unless of course there is an alternative political motive?

If my concerns are not to be considered by someone able to give a meaningful response, then please do not insult my intelligence by sending me another “off the shelf” or “cut and paste” reply. I will instead arrange for a constituent of Mr Hunt’s, in Farnham to pass copies of my correspondence to him in person.

I look forward to hearing from you, if you are able to be polite enough to actually give consideration to my questions:

1. Why leak details of a health policy that is not yet finalised knowing the response?

2. Does Mr Hunt acknowledge that the leaking of policies leads GPs to be suspicious of the leaking of any data on cancer referrals that is gathered?

3. Does Mr Hunt acknowledge that gathering such data will lead to an increase in referral rates, with no guarantee of increased diagnosis rate?

Yours sincerely

 

Response from Department of Health to letter with 850 signatures to Jeremy Hunt about “naming and shaming”

Our ref: DE00000872042  

  Dear Dr Dawlatly, 

  Thank you for your emails of 7 and 8 July to Jeremy Hunt, with a petition attached, about the recent announcement that data about GPs who fail to diagnose cancer in their patients will be published online.  I have been asked to reply. 

I note your concerns about the proposed scheme.

 The Government recognises the vital role GPs play in the health service.  It also knows how hard GPs work to provide good quality care, and ministers expect GPs to use their clinical judgement in referring patients to cancer services.

 The Department is looking at a range of different ways to increase the early referral of patients with symptoms of cancer.  This includes being transparent about GP referral data, which ministers hope will help to improve consistency and cancer survival rates across the health service. However, the proposals for such a scheme have not yet been finalised.

 Generally, the earlier a cancer is diagnosed, the greater the chance of survival.  This is why the Department has invested more than £450million of additional funding to achieve the earlier diagnosis of cancer.  This funding is designed to support better GP access to key diagnostic tests and to meet the costs of additional tests and treatment in secondary care.  It also supports the ‘Be Clear on Cancer’ campaigns, which aim to raise awareness of potential cancer symptoms and encourage people to visit their GP.

 I am sorry I cannot be more helpful.

Yours sincerely, 
  
Lindsey Cox 
Ministerial Correspondence and Public Enquiries
Department of Health 

You can contact the DoH yourself via: 

http://www.info.doh.gov.uk/contactus.nsf/memo?openform

I plan to write a response sometime soon…

I can’t prescribe you a new job – published in BMA News 19 July 2014

“Hello, my name is Dr Sam Dawlatly, sorry to keep you waiting. Come on in and take a seat.”

“Yes fine thank you, how are you?”

It always amuses me how my opening patter is not actually taken in at all by new patients. They are probably busy rehearsing their opening lines.

“So, what brings you here?” I ask as I settle in my chair.

“Actually, I’ve come for a bit of advice…”

I nod and resist the urge to flick though the patient summary as he talks.

“I’m not actually sure it’s a medical problem, but as you had a free appointment, you know free of charge as well as available-free, I thought I would come and chat things over with you,” he said, “Is that OK?”

“Go ahead,” I said flatly, whilst trying to guess whether the issues  was work, housing, relationship or family. My money was on work.

After a brief pause, he continued, “You see, it’s my job…”

“Bingo!” I thought, already rehearsing my reply, “Well I can’t prescribe you a new job, you know!”

“… you see my job is kind of stressful. It always has been. And I knew that would be the case when I embarked on the training. I have a lot of responsibility to bear, the welfare of the members of the general public that I see, but also the people that work for me and my business partners to bear in mind…”

My heart sunk as I heard the hope in his voice that I could make a difference. Did he think I was some sort of career advisor?

“… Well the fundamentals of the job are stressful enough. But things are getting worse.”

“In what way?” hoping that I sounded and looked more interested than I felt. I lay my hands in my lap and crossed my legs to mirror him, then leaned forward slightly. The computer hadn’t gone onto screensaver yet.

“Well here’s the irony, the people I come to see, do so just because they can, at the drop of a hat, for the slightest reason and expect me to solve things that are outside of my ability, qualifications and job description. Things that I am not paid to do.” He paused and looked straight at me.

“Just like you are doing now!” I thought, holding my tongue.

“Just like I’m doing right now,” he echoed my thoughts perfectly.

It was then that I noticed that he was wearing my shoes, my trousers, my shirt, but I couldn’t quite see his face…

I startled as the phone rang and lifted my head off the desk. I was all alone in the consulting room. I picked up the phone.

Getting on the front page of a National Newspaper

How does that feel?

The BMA have kindly posted my reflection on the process of writing a protest letter  and being part of the process of gathering 650+ signatures. It’s about naming and shaming of GPs. The BMA would be very grateful if any of you could pop over to their website to take a look and comment.

http://bma.org.uk/news-views-analysis/work/2014/july/the-name-and-shame-attack-on-gps

 
Please pass on to anyone else who might like to read it