Doctors are being warned to take extra care when using social media websites such as Facebook and Twitter.
The British Medical Association guidance highlighted a series of potential pitfalls doctors face.

In particular, it said there was a risk the lines between personal and professional lives could be blurred.

It comes after a series of cases in which NHS staff and other public sector workers have got into trouble through their use of social media.

In 2009, a group of doctors and nurses were suspended for posting pictures of themselves on Facebook lying down in unusual places, including a hospital helipad.

And last year a civil servant found herself in the newspapers after using her Twitter account to make political points and saying she was struggling with a hangover.

Dr Tony Calland, chairman of the BMA’s medical ethics committee, said: “Medical professionals should be wary of who could access their personal material online, how widely it could be shared and how it could be perceived by their patients and colleagues.”

The guidance advises both doctors and medical students to adopt conservative privacy settings where they are available.

It also warns them against making informal or derogatory comments about patients or colleagues as well as not accepting current or past patients as friends on Facebook.

The message was echoed by the Nursing and Midwifery Council (NMC), which has also issued its own guidance this week.

NMC official Andy Jaeger said: “What you regard as just an amusing story could end up causing serious offence more easily than you think.”

From: http://www.searchclinic.org/doctors-warned-over-facebook-risks.htm

David Cameron has agreed to make changes to the plans for the NHS in England and insisted the government had not made “a humiliating U-turn”.
Ministers have accepted all the recommendations suggested by a panel of experts, including more controls on competition and a slower pace of change.

Doctors’ groups have broadly welcomed the revisions.

The NHS bill will now go back to the committee stage in the House of Commons to be scrutinised again by MPs before going through its House of Lords stages.

The prime minister’s official spokesman said he expected that to happen before the summer recess begins in July, and the bill to be on the statute book by the end of the current Parliamentary session.

That gives ministers until May 2012 to make it law.

On Monday – following a 10-week “listening exercise” – a panel of experts called the NHS Future Forum gave its recommendations on the changes needed to the bill.

They include:

• Reinstating the legal responsibility of the health secretary for the overall performance of the NHS
• Scrapping the primary role of the regulator, Monitor, to promote competition – and focusing on improving patient choice instead
• Relaxing the 2013 deadline for new GP commissioning arrangements to be introduced – a National Commissioning Board, based in Leeds, will control budgets until GP groups are “able and willing” to take over
• Strengthening the power of health and well-being boards, which are being set up by councils, to oversee commissioning and giving patients a greater role on them
• Retaining a lead role for GPs in decision-making, but boosting the role of other professionals such as hospital doctors and nurses alongside them

After criticism from medics and complaints from rebellious MPs, the Coalition will be hoping the dust will now settle over its NHS reforms.

If politics is the art of persuasion, then the test for Messrs Cameron, Clegg and Lansley is whether or not they have convinced people that the listening process has been, as the prime minister claimed, a sign of strength.

The government and many health professionals believe changes to the NHS are necessary to deal with the demands of the ageing population, cost of new drugs and lifestyle changes such as obesity.

Mr Cameron said those who described the reworking of the plans as “a humiliating U-turn”, or the listening exercise as “a big PR stunt”, were both wrong.

“The fundamentals of our plans – more control to patients, more power to doctors and nurses, less bureaucracy in the NHS – they are as strong today as they’ve ever been,” the PM said.

The health secretary has faced personal criticism for his inability to garner widespread support for the original bill, but the prime minister said he accepted full responsibility for what had happened.

“I am every bit as responsible as Andrew Lansley for the fact that we actually decided we could improve on what we already put forward,” Mr Cameron said.

The British Medical Association said it was pleased the government had accepted the Future Forum’s recommendations and addressed many of doctors’ concerns.

But it said more detail was needed on how commissioning of care would work in future and there must be “robust safeguards” to prevent competition of any kind destabilising the health service.

From: http://www.bbc.co.uk/news/uk-politics-13757380

Leading health organisations have slammed the Government’s “responsibility deal” on alcohol and refused to sign up as partners.
The six organisations, including Alcohol Concern, the British Medical Association and the Royal College of Physicians, accused the Department of Health of allowing the drinks industry to dictate health policy.

Under the deal, the drinks industry would be asked to sign up to a number of alcohol pledges.

These reportedly include ensuring 80% of products on the shelf are labelled for unit content, raising awareness of the unit content of drinks in pubs and clubs and taking action to reduce under-age drinking.

There would also be a pledge to commit to action on advertising and marketing by promoting responsible drinking and keeping alcohol adverts away from schools.

But the six organisations which had been involved in the Government’s Responsibility Deal Alcohol Network (RDAN), which also include the British Association for the Study of the Liver, the British Liver Trust, and the Institute of Alcohol Studies, refused to support the deal.

They said the pledges were neither specific nor measurable, that they lacked scope and that there was no evidence such voluntary interventions would be effective.

The statement read: “We have not yet seen evidence that Government is working towards a comprehensive, cross-departmental strategy to reduce alcohol harm, based on evidence of what works, with rigorous evaluation metrics.”

The organisations called on the Government to provide:

• A clear and firm commitment on how it intends – via evidence based policy – to tackle affordability, availability and promotion of alcohol as part of a cross-government strategy;

• A clear presentation of the steps that will be taken if the current RDA objectives are not met in 12 months’ time;

• A firm commitment to consider change – including through regulation – if voluntary commitments from business are not met after an agreed time period.

Don Shenker, chief executive of Alcohol Concern, said: “This is the worst possible deal for everyone who wants to see alcohol harm reduced.

“There are no firm targets or any sanctions if the drinks industry fails to fulfil its pledges.  It’s all carrot and no stick for the drinks industry and supermarkets.”

“By allowing the drinks industry to propose such half-hearted pledges on alcohol with no teeth, this Government has clearly shown that when it comes to public health its first priority is to side with big business and protect private profit.”

Dr Vivienne Nathanson, director of professional activities at the BMA, said: “The Government has talked the talk in respect of wanting to tackle alcohol misuse but when it comes to taking tough action that will achieve results, it falls short.

“Instead it has chosen to rely on the alcohol industry to develop policies – given the inherent conflict of interest these will do nothing to reduce the harm caused by alcohol misuse.”

Katherine Brown, Head of Research and Communications at the Institute of Alcohol Studies, said: “The most effective means of reducing alcohol-related harm is through adjustments in affordability, availability and promotion.

“These policies are supported by a broad evidence base and have been recommended to Government by a recent cross party House of Commons Health Committee report.

“The Responsibility Deal fails to address any of these policy areas and we are yet to see any real proof that Government is looking into developing a cross-departmental comprehensive alcohol strategy, based on evidence of what works.”

Alison Rogers, chief executive of the British Liver Trust, said: “For more than 10 years we have been persuaded to play the long game, sitting and watching the alcohol industry cultivate their relationship with the Government.

“Now it must stop for the sake of the 100 families losing loved ones each week from alcohol-related liver disease.”

And Sir Ian Gilmore, the Royal College of Physicians’ special adviser on alcohol, said: “The industry pledges published in various newspapers do not give practising doctors, who see the rising tide of health harm from drink in their daily practice, any confidence that they will get to the core of how we reverse this entirely preventable cause of illness and death.”

Sir Ian was among a trio of experts who recently warned the Government that up to 250,000 extra lives could be lost in the next 20 years in England and Wales unless tough restrictions on alcohol are introduced.

The liver death rate in the UK is 11.4 per 100,000 people, more than double that of other countries with similar drinking cultures, including Australia and Holland.

Health Secretary Andrew Lansley said: “We have made clear from the start that the responsibility deal is just one strand of the Government’s wide public health policy. It explicitly excludes cost and price competition to avoid conflicts of interest.

“The Treasury have already announced an introduction of a new tax on super-strength beers; the Home Office have made their announcement on a ban in sales of alcohol below cost and plans to tighten licensing laws; and, our public health strategy sets out how local areas will be given a ring-fenced public health budget to ensure alcohol misuse gets the priority it deserves.

“In tandem to this action, the responsibility deal is working with the industry on voluntary agreements to get speedier results. For example, to improve unit labelling. The Responsibility Deal has achieved more in the last six months than the previous Government’s Coalition for Better Health did in a year and a half. What is more, this is only the first step.”

From: http://www.independent.co.uk/health-bodies-attack-government-alcohol-plans

The British Medical Association (BMA) has renewed its call for England to abolish prescription charges, after it was announced that they will rise from £7.20 to £7.40 on April 1 and Scotland abolishes them altogether.
The government in England  “should be following the lead set by the three other nations in the UK and making plans to abolish them,” said Hamish Meldrum, chairman of council at the BMA.

The current system is “a chaotic and unfair mess – patients in England have to pay, while those in Wales and Northern Ireland do not,” and from April 1 Scotland will completely scrap its charges, “a move that further exaggerates the absurd postcode lottery that exists in the UK,” said Dr Meldrum.

“The bureaucracy needed to administer prescription charges is cumbersome, many of the exemptions are confusing and unfair. Patients with disabling long term conditions still have to pay them, despite a recent report recommending they be phased out,” he added.

The BMA accepts that these are financially difficult times, said Dr Meldrum but, he added: “this is a tax on the sick that contributes only a modest amount to the NHS budget and does not offset the unfair disadvantage of asking the ill to pay for their medicine.”

Responding to the BMA’s charges, a Department of Health official claimed that around 90% of prescription items in England are already dispensed free of charge, and that the price of the 12-month prescription pre-payment certificate is to be frozen for the second year running, allowing patients to get all the prescriptions they need for an average of £2 a week.

Moreover, abolishing prescription charges in England would lead to a shortfall for the NHS of more than £450 million a year, equivalent to the salary costs of nearly 18,000 nurses, or 15,000 midwives or more than 3,500 consultants, the official added.

The Scottish National Party (SNP) pledged to scrap prescription charges during its election campaign in 2007, and since then the price has dropped each year. Last week, the Scottish Parliament’s health committee voted to finally remove the charge, which now stands at £3, defeating a last-minute attempt by Scottish Conservative Member of Parliament (MSP) Mary Scanlon, -  with the sole support of Liberal Democrat MSP Ross Finnie – to retain it.

Scottish Public Health Minister Shona Robison described free prescriptions as “a long-term investment in improving health” and dismissed allegations that the measure “will only help those people who are described as rich.”

“If people are put off seeking appropriate care for financial reasons their health will not improve, but if patients can get the treatment they need it will not only help their health but ultimately help to reduce the longer-term costs to the health service as well,” said Ms Robison. “Importantly, abolition will help all those people who have long-term health conditions which don’t currently entitle them to exemptions,” she added.

From: http://www.pharmatimes.com/Doctors_slam_UK_prescription_charge_lottery

The Government cannot afford to delay essential reform of Britain’s public services, David Cameron warned yesterday.
As ministers prepared to publish legislation to radically overhaul the NHS, the Prime Minister said that failure to modernise was draining resources away from the public sector.

The Government’s plans for the NHS were denounced by six health service unions – including the British Medical Association and the Royal College of Nursing – as “potentially disastrous”.

But Mr Cameron insisted that change was essential.

“Every year without modernisation the costs of our public services escalate. Demand rises, the chains of commands can grow, costs may go up, inefficiencies become more entrenched.

“Pretending that there is some ‘easy option’ of sticking with the status quo and hoping that a little bit of extra money will smooth over the challenges is a complete fiction.

“We need modernisation, on both sides of the equation. Modernisation to do something about the demand for healthcare, which is about public health. And modernisation to make the supply of healthcare more efficient, which is about opening up the system, being competitive and cutting out waste and bureaucracy.

“Put another way: it’s not that we can’t afford to modernise; it’s that we can’t afford not to modernise.”

With the Government also set to publish details of its school reforms next week, Mr Cameron cited the experience of Tony Blair, who found that delaying public service reform simply resulted in “institutional inertia” against change.

He acknowledged that in the past the Conservatives had not always shown sufficient respect for those who worked in public services, but insisted he would “revere, cherish and reward” an ethos of public service.

“I believe previous Conservative governments had some really good ideas about introducing choice and competition to health and education – so people were in the driving seat. But there was insufficient respect for the ethos of public services – and public service,” he said.

“The impression was given that there was a clear dividing line running through our economy, with the wealth creators of the private sector on one side paying for the wealth consumers of the public sector on the other.

“This analysis was – and still is – much too simplistic. Public sector employees don’t just provide a great public service – they contribute directly to wealth creation.”

He denied he was planning “a kind of public service version of a laissez-faire economic policy” with the Government’s reforms for schools and hospitals, “where winners are created at the expense of those who get left behind”.

“The state has a hugely important responsibility to ensure clear, basic standards are met, the rights of users are maintained and independent inspection is carried out in our public services and we are in no way abrogating that,” he said.

The Prime Minister also rejected suggestions that the Government was trying to do “too much at once” in pushing through change.

“Every year we delay, every year without improving our schools is another year of children let down, another year our health outcomes lag behind the rest of Europe, another year that trust and confidence in law and order erodes,” he said.

“These reforms aren’t about theory or ideology – they are about people’s lives. Your lives, the lives of the people you and I care most about – our children, our families and our friends. So I have to say to people: if not now, then when? We should not put this off any longer.”

Mr Cameron also explained comments in which he appeared to describe the NHS as a second rate National Health Service as a slip of the tongue.

His slip-up came during a radio interview this morning on BBC Radio 4′s Today programme.

Asked if he would apologise for using the term, Mr Cameron said: “I think if you listen to the interview, I immediately said we shouldn’t settle for second best and that is exactly what I meant to say.

“I speak often quickly, I don’t just have a pre-arranged order of saying things and sometimes you can get a little word out of place and I immediately said, if you listen to the clip, we shouldn’t settle for second best, that was the point I was making.”

To widespread guffaws from the assembled media, he added: “We shouldn’t settle for second best is what I meant, it’s largely what I said, if you skip over a quick word in the middle.”

In a letter to The Times today ahead of Wednesday’s publication of the Health and Social Care Bill, the heads of six health unions expressed their “extreme concerns” about plans to create greater commercial competition between the NHS and private companies within the health service.

The signatories, including BMA chairman Hamish Meldrum, RCN chief executive Peter Carter and the heads of health for the Unison and Unite unions, said: “There is clear evidence that price competition in healthcare is damaging.”

It follows a report by the NHS Confederation which acknowledged the potential benefits of the changes, which will give GPs power over commissioning treatment, but warned they were “extraordinarily risky” at a time when the NHS is facing its toughest financial constraints for a decade.

From: http://www.independent.co.uk/we-cannot-afford-not-to-reform-nhs-says-david-cameron

The Summary Care Record IT program  is to go ahead, but its content will be limited to core information with an opt out form will be included in patient information packs.

The Department of Health has published the results of two simultaneous reviews of the SCR, covering the content of the record and the information patients receive before their record is uploaded.

The reviews were set up by the coalition government this summer, following concerns about patients’ awareness of the SCR and the kind of information added to it. This had led to the suspension of further patient information programmes.

The review of the content of the record, led by NHS medical director Sir Bruce Keogh, concluded that the core record should only contain a patient’s demographic details, medications, allergies and adverse reactions, and that these should continue to be copied from the GP’s medical record.

The review group said the DH should only consider expanding the content of the record “when we have built trust in the system and when patients request that we should do so.”

Sir Bruce said: “In an advanced national health system, it is reasonable for citizens to expect that when they arrive in accident and emergency or require treatment out of hours, the clinicians treating them have access to enough basic medical information to prevent anyone making wrong or even dangerous decisions.”

The separate Patient Information and Preference Review group, led by national director of patient and public affairs Joan Saddler, concluded that an opt-out form should be included in the patient information packs, and that these should also be simplified.

It said services such as HealthSpace should also continue to provide access to SCRs.

Almost 30m patients have already received information about the SCR but the review concluded that there should be no requirement to send another letter to those patients.

However, it said but there should be awareness raising campaigns at local, regional and national levels to ensure patients realise that an SCR is being created for them unless they choose to opt out.

Health minister Simon Burns said he was pleased that a consensus had emerged about the importance of the SCR in supporting safe patient care, so long as the content of the record was limited to core information.

He added: “Coupled with improvements to communication with patients which reinforce their right to opt out, we believe this draws a line under the controversies that the SCR has generated up to now.

“We see this review as having taking a significant step towards the goal of patients owning their records and using them to share decision-making with healthcare professionals.”

A BMA spokesperson said: “We welcome the progress that has been made towards an emergency electronic record that supports urgent care, yet recognises many of the understandable concerns of patients and clinicians.

“Much will depend on the way the amended scheme is put into practice, and the BMA looks forward to continuing our work with government on its implementation. It is essential that patients have genuine control over who has access to their records, and when changes are made to them.”

The review groups concluded that patients should play a key role in deciding the evolution of the record and that new arrangements should be introduced to define responsibility for decisions about the introduction of any new content to the record.

They said the principle should be that any change to the scope of the record should be driven by citizens and patients with appropriate advice from professional bodies and in line with the IT capability.

Saddler said the availability of core information when patients need care was essential if patients were to be at the heart of care but it should also be easy for patients to opt-out.

She added:”Patients must be the ones who decide if any additional information should be included in their SCR, supported by appropriate professionals. This is the only way we will build trust in the SCR and its use.”

The SCR Content Review group said standards should be defined to support a patient’s wish to add information to their SCR such as end of life preferences, a care plan for patients with long term conditions or the inclusion of a patient’s significant medical history.

The review groups, which between them took evidence from almost 50 bodies, said it had heard strong opinions that the use of smartcards was not universal within GP practices which had implications for accurate updating of the SCR.

The reviews said use of smartcards was outside their remit but recommended that further options were investigated to mitigate the risk of practices not using smartcards.

The review group on Patient information and Preferences also recommended that the outer envelope that patients receive should have clear emphasis that the information contained in the envelope is about “Your health records, you need to make a choice.”

John Heyworth, president of the College of Emergency Medicine, said the college welcomed the decision to proceed with the SCR.

He added: “Clinicians working in emergency departments are currently often deprived of key background and patient information, particularly during the initial phase of time critical treatment and this may significantly compromise the quality and safety of care provided.

“Immediate access to such records will lead to better and safer care for our emergency patients.”

The review’s conclusions were backed by a range of bodies including the Patients’ Assocation, The Royal College of Nursing, Asthma UK and Sue Ryder Care.

From: http://www.e-health-insider.com/summary_care_record_given_go-ahead

Bonus payments given to thousands of doctors on top of their six figure salaries are to be slashed as part of a Government clampdown.Most hospital consultants currently receive an annual merit award, which gives them up to £76,000 on top of an average salary of £110,000.

Once a medic is on the scheme, they almost always stay on it for life, with the fund counting towards their pension.

In August, Health Secretary Andrew Lansley ordered an overhaul of the whole system, which has just paid more than 1,700 doctors more than £45,000 each, on top of their salaries.

Now medics have been told that until this review reports, the fund for all new payments made by local hospitals will be cut by more than 40 per cent. Meanwhile, the number of new awards made by the national part of the scheme has been halved.

While maximum levels remain the same – at £76,000 for those who get a payout from the Department of Health, and £35,000 for those rewarded by their local hospital, the pot will be shared among fewer medics.

New figures show that this year, 300 consultants received a “platinum” award of £75,800 in bonuses. Another 623 took home “gold” rewards of more than £55,000, and 847 were given more than £46,000.

Consultants have been given rewards above basic salary ever since the NHS was created in 1948.

But they have become more contentious since a new contract, introduced in 2003, increased the average salary by one third, to £110,000, as working hours fell.

This year, more than half of consultants received some sort of merit payment, under schemes set up to reward those who have made outstanding contributions to patient care or research.

The British Medical Association is threatening to take legal action over the new cuts, which will take effect in April.

The chairman of its consultants committee, Dr Mark Porter, said ministers were sending out an “appalling” message to the NHS.

The union has written to Mr Lansley, objecting to the latest changes, and is exploring whether legal action can be pursued.

Dr Porter told The Sunday Telegraph: “This is a really appalling way to treat doctors.

“We understand that there is a difficult position with public spending, but to specifically hit out at those doctors who are performing at the highest levels – those who go the extra mile – and decide to take investment from them, sends out a terrible message.”

Alan Maynard, Professor of Health Policy at York University said the Government was right to attempt to clamp down on a scheme which he described as “extraordinarily generous and poorly policed”.

He said: “These payments are supposed to reward particular excellence, and supposed to be subject to regular review.

“In fact, once an award is made, it is almost always for life, and these sums augment doctors’ pensions by an enormous amount.”

Emma Boon, from the TaxPayers’ Alliance, said that while consultants did an important job, the increases to their incomes in the last decade had been “astonishing”.

She said: “We need to ensure value throughout the NHS, and that means we can’t afford to sustain payments at these levels. Though doctors deserve decent rewards, we should be careful not to overcompensate them for the work they do.”

The Department of Health said the changes reflected the “challenging financial environment” the NHS was working in.

A spokesman said the Government wanted to reward those who went beyond the call of duty, and said the best consultants would still receive awards.

From: http://www.telegraph.co.uk/Bonus-payments-to-doctors-on-six-figure-salaries-set-to-be-slashed

Bringing more competition to the NHS under White Paper reforms would be “potentially damaging” the British Medical Association (BMA) argues.A market-led approach “creates waste, bureaucracy and inefficiency”, Dr Hamish Meldrum, chairman of council at the BMA, said.

Under proposals put forward in July by Andrew Lansley, the Health Secretary, GPs are to be given the power to manage £80 billion of the NHS budget to buy care from hospitals and other doctors, while tiers of management are to be axed.

The BMA said today- Friday, that while it was “interested” in these proposals, the greater efficiencies they could bring might be undermined by more private sector involvement.

Dr Meldrum said: “There are proposals in the White Paper that doctors can support and want to work with. But there is also much that would be potentially damaging.

“The BMA has consistently argued that clinicians should have more autonomy to shape services for patients, but pitting them against each other in a market-based system creates waste, bureaucracy and inefficiency.”

Dr Meldrum said that while he was “not ideologically against markets” he did not believe the evidence showed they had worked in the NHS so far.

Private finance initiatives and privately-run treatment centres, which sold their services to the NHS, resulted in taxpayers’ money leaving the service, he said.

“The private sector is not doing this out of some great social generosity, they want to make a profit,” he argued.

He was talking as the BMA submitted its response to the White Paper: Equity and Excellence: Liberating the NHS.

From: http://www.telegraph.co.uk/BMA-says-White-Paper-reforms-potentially-damaging

A political row has erupted after Andrew Lansley the health secretary was accused of making “a significant U-turn” over plans to scrap NHS Direct, in the face of widespread public anger.
Andrew Lansley said that NHS Direct would remain but that its telephone number would be replaced so that from 2013 people could call 111 for non-emergencies and 999 for emergencies.

“I have not announced plans to scrap NHS Direct. I have announced plans to phase out the NHS Direct number,” the health secretary said in a letter.

This appears to contradict statements from the Department of Health last month, including to the BBC, that said the service would be scrapped. The new 111 helpline is already being piloted in the north-east of England.

However, there are concerns that fewer medical staff will be employed by the new service. NHS Direct employs 3,400 people, 40% of whom are trained nurses. It was reported that the ratio for the new helpline would be lower.

The threat to the telephone service, which costs £123m a year to run, provoked an immediate backlash. In the fortnight since the story broke, more than 16,000 people have signed a petition to save NHS Direct, which provides general health advice and information about out-of-hours GPs, walk-in centres, emergency dentists and 24-hour chemists.

Lord Prescott, the former deputy prime minister, played an active role in the campaign – including changing his Twitter picture to a “Save NHS Direct” badge.

Significantly, the Royal College of Nursing said it would be “shortsighted” of ministers to axe a service that had saved the NHS more than £200 million by dispensing advice over the phone.

Labour attacked Lansley for a “significant U-turn” that had seen the health secretary “rowing back” from previous statements. “It’s an incredible victory for the campaign to save NHS Direct,” said Andy Burnham, Labour’s leadership contender and spokesman for health.

A series of letters between Lansley and Burnham, the previous health secretary, reveals a combative exchange. Burnham accused his Tory counterpart of “misrepresenting his position” as Lansley claimed that the 111 number was Labour’s idea and he was “getting on with what you failed to do”.

In a statement the health secretary said: “This is the latest political stunt from [Burnham]. He seems more concerned with trying to boost his leadership campaign than discussing our policies accurately.”

Unions warned that the future of medical staffing levels in the new service would remain an issue. Dave Prentis, general secretary of Unison, said: “Staff will still be confused and worried the government may have another change of heart. I would like a guarantee from the health minister that the 1,300 nurses working for NHS Direct will still have a job there this time next year.”

Despite its popularity, the medical establishment has been divided over the benefits of phone line. Earlier this summer British Medical Association chairman Dr Laurence Buckman said that getting rid of NHS Direct could be one way of cutting back on spending — adding that the “expensive” phoneline delayed healthcare reaching patients.

From: http://www.guardian.co.uk/nhs-direct-closure-Andrew Lansley backtracks

The declining role of GPs in maternity care is leading to some pregnant women feeling “abandoned” by the system, a leading think-tank has claimed.
Often expectant mothers do not know who to turn to if they suffer health problems during pregnancy, according to The King’s Fund.

Although family doctors frequently know a woman’s medical history best, their role in pregnancy care has become sidelined in recent decades, found the authors of the report, The role of GPs in maternity care – what does the future hold?

The King’s Fund concluded that GPs’ role in maternity care had “all but disappeared over the past 30 years, with recent policy and guidance omitting any reference to their role in caring for pregnant women”.

“Under the terms of the new GP contract introduced in 2004, GPs are no longer paid for each pregnant woman they look after,” it noted.

“In addition, many GPs have opted out of providing out-of-hours care, resulting in sick pregnant women going to A&E with pregnancy-related problems – or simply not knowing what to do if they are ill.”

Nick Goodwin, director of the Fund’s GP Inquiry, said such care was increasingly dealt with by specialists, which had led to a less connected service for pregnant women.

He said: “As a result of that you get reports that some mothers feel a bit abandoned at the beginning of their pregnancy. Who is looking after them?”

Sometimes pregnant women’s other health needs – like mental health issues and obesity – were not being dealt with, he said.

“More needs to be done to make sure that the whole person is treated.”

The report proposed that GPs should now take “a more active role”.

Anna Dixon, lead author of the report and director of policy at The King’s Fund, said: “It is right that those with specialist skills, such as midwives and obstetricians, take the lead role in caring for pregnant women but GPs have a vital role to play in pre-conception and shared ante-natal and post-natal care.”

The report has been widely welcomed by GPs’ groups.

Dr Laurence Buckman, chairman of the BMA’s GPs Committee, said: “GPs want to be more involved in maternity care because they see it as an important part of their job.”

Prof Steve Field, chairman of the Royal College of General Practitioners, welcomed the “timely” report, saying it made “a very compelling case for GPs to play a more central role”.

However, Belinda Phipps chairman of the National Childbirth Trust, which campaigns for less medical intervention during pregnancy and birth, said it would be better to “actively promote midwife-led care to women”.

From http://www.telegraph.co.uk/Pregnant-women-feel-abandoned-by-NHS