A terminal illness?

<em>NHS in crisis</em> - What can be done to rescue the NHS?

Every day, in every part of the country, GPs are literally taking the temperature of the nation. Likewise, as the guardians of entry to the NHS, family doctors are uniquely placed to monitor the health of this doddering old institution. Today, their prognosis is that the vital signs are not good.

They could be wrong. With an average of seven minutes per patient, is it any wonder that the quality of care suffers? Yet still the government demands that GPs see all patients, regardless of need, within 48 hours.

The way to achieve quality, according to ministers, is through the enforcement of endless guidelines and regulations. In reality, they are crushing the life out of the medical profession. They demand evidence-based healthcare, but refuse to base their own relentless reforms on any kind of cost-benefit analysis. Meanwhile, public expectations are raised with high-profile targets that cannot be reached without more doctors, more funding and better management.

Hence the ballot of GPs last year, in which 86 per cent threatened to resign in April 2002 if their concerns were not addressed in a new employment contract.

So far, negotiations have progressed slowly. But now we hear that the Prime Minister is taking charge of the crisis in the NHS. Please, Tony, the last thing we need is more ill-conceived reforms. You are very fond of saying that we should listen to patients to find out what is wrong with the NHS. But as the debate about the future of the NHS reignites, it's time you listened to the doctors to find out how to put it right.

Colin Cooper is editor, ofGP magazine

(www.healthdebate.co.uk)