Sajid Javid’s criticisms of how GPs work have fuelled a rise in verbal and physical attacks on them and their staff, the leader of Britain’s family doctors has claimed.
Dr Richard Vautrey said comments by the health secretary and NHS bosses, alongside negative coverage of GPs in some newspapers, had wrongly made the public think they were “hiding away” from patients, and exposed staff to abuse.
Vautrey, the outgoing chair of the British Medical Association’s GPs committee, made the claim in an interview with the Guardian before the union’s decision on Thursday about whether to press ahead with industrial action in protest at a government edict that GPs in England must see any patient face to face if requested.
Before the pandemic 80% of consultations in England were face-to-face. That fell dramatically on government and NHS orders when the Covid pandemic struck, though in recent months it has risen again to 60%.
Vautrey said: “We’ve gone from the clapping and support of the general public to the huge criticisms of, and unacceptable abuse that’s been levelled at, GPs and their teams both from certain sections of the media but also fuelled by government comments and NHS England comments, which have been completely unacceptable.
“Both the secretary of state and NHS England overtly supported the campaigning of some sections of the media. And that then fuelled the anti-GP rhetoric, not just nationally, but also locally.
“Our reception staff particularly have been on the end of almost daily abuse from individuals calling them, understandably frustrated that they’re waiting for an appointment or waiting for a procedure, and [have] not been able to get exactly what they want. But nevertheless that national tone has then led to our practices being under fire.”
He added that individuals had been “subjected to physical abuse as well as verbal abuse – this is unacceptable and yet we’ve not seen the government call that out and take it seriously”. There have been “some horrendous examples” in recent weeks including one in which a GP’s skull was fractured.
Last month the BMA’s GPs committee voted unanimously to reject a plan by Javid which included “naming and shaming” surgeries that see too few patients in person, and hold a ballot on possible industrial action, which could result in family doctors at the 6,600 practices in England reducing the work they undertake.
However, Vautrey stressed that doctors would keep seeing patients. “GPs are on the side of their patients … None of the [four types of protest action proposed in the indicative ballot] would have an impact on patient care. GPs do not do anything that would put their patients at risk. This is all about getting the government to listen to the needs of GPs, practice nurses and practice managers,” he said.
In his only interview since announcing he will stand down this week, Vautrey, a GP in Leeds, also:
Called ministers “hypocritical” for encouraging GP surgeries to offer virtual appointments by phone or video call in the years before and during the pandemic but now mandating in-person consultations.
Claimed Javid had torn up the standard practice of the Department of Health and BMA negotiating changes to GPs’ working practices. “There were no negotiations. We were presented with a fait accompli. We were ignored.”
Attacked NHS England for helping Javid draw up and then publish his plan to expand face-to-face appointments, which has sparked fury among GPs, saying: “They’re equally complicit in this.”
He accused the government of trying to shift the blame for the NHS’s growing problems on to GPs to deflect attention from its own failed stewardship of the health service. “There’s been attempts to distract from the almost weekly headlines now [showing] the pressure that the NHS is under. And so often it’s GPs who are blamed for that, completely wrongly. It’s distracting from their failings.
“GPs are being blamed for things which are out of their control. We need proper support, additional staff and better premises. The government aren’t showing signs of addressing that properly and yet are all too quick to blame GPs for failings which are theirs, not the profession’s.”
Referring to the health secretary’s five months in the post, Vautrey said Javid had been too focused on hospitals and the NHS backlog and not enough on helping GPs, many of whom are quitting or going part-time in response to heavy workloads.
“He’s so far proved too quick to support the populist media and far too slow to support the profession. Sajid Javid still doesn’t understand the nature of general practice in the way that he has to,” Vautrey said.
Javid told MPs this month that patients were adding to the overload at A&E units because they could not get a GP appointment, saying: “A significant portion of people are turning up for emergency care when they could have actually gone to their GP. Part of the reason that I think people are turning up at A&E, perhaps when they do not need it, is that they are not able to get through to their primary care services in the usual way.”
Last week the Royal College of GPs (RCGP) wrote to Javid disputing that and asking him to provide evidence. NHS Providers, which represents hospital trusts in England, backed the RCGP.
Vautrey also warned that a rise in face-to-face appointments could put patients in danger of catching Covid in waiting rooms. “It is irresponsible for the government to suggest to patients that we can return to a situation that was the case pre-pandemic where we had crowded waiting rooms. We can’t go back to that sort of situation when we’ve got Covid rates at the levels we have at the moment. For anyone to suggest that is potentially putting patients and our staff at risk.”
A Department of Health and Social Care spokesperson said: “This government takes a zero-tolerance approach to violence and abuse whenever it arises and it is completely wrong to imply ministers would do anything but support GPs. The last 18 months have been extremely challenging and we’re incredibly grateful for the phenomenal work of our NHS staff including GPs and their teams. Practices have been open and busy throughout the pandemic, offering both in-person and remote consultations.
“We know that general practice is busy and demand for services is high, that is why we have set out a plan to provide targeted support to help them continue to improve access – backed by a £250m winter access fund.”