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The Policy Ask with Kamila Hawthorne: “GPs should be caring for patients, not ticking boxes”

The chair of the Royal College of GPs on the importance of family doctors and the urgent need to tackle health inequalities.

By Spotlight

Kamila Hawthorne is the chair of the Royal College of GPs (RCGP), the professional membership body for general practitioners in the UK and abroad. She is also a practising GP in South Wales, and holds an academic role as head of graduate entry medicine at Swansea University. Originally from Tanzania, she has worked as a doctor in the UK for nearly 40 years and has a special interest in diabetes, health inequalities and medical education. She was appointed an MBE in 2017 for services to general practice and her work on diabetes health education within black and minority ethnic communities.

How do you start your working day?

Porridge and coffee. Then, if I’m in surgery, I look through my morning patient list, check in with practice colleagues, and start working through any pathology results that have come in. On RCGP days I review any urgent media and public affairs requests that are outstanding or have come in overnight.

What has been your career high?

I passed my Royal College of Physicians exam (for hospital physicians) first time, while still training to be a GP. It had a reputation for being really hard to pass, and was definitely one of the most difficult things I’ve ever done. It gave me confidence to do anything I set my mind to.

What has been the most challenging moment of your career?

I spent three years working with the University of Surrey putting together a bid to set up a new medical school. Unfortunately it was unsuccessful. I vividly remember feeling a sense of numbness at all the time I thought had been wasted – but then another door opened at Swansea University, where I became head of graduate entry medicine.

If you could give your younger self career advice, what would it be?

I’d tell myself to have confidence and courage. It won’t be straightforward, but if you really want to do something, you will probably get it, or something better, in the end. Keep your head and be yourself. This is what I tell medical students and my younger colleagues in training.

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What political figure inspires you?

Jacinda Ardern exudes integrity and kindness, and kept New Zealand safe during Covid. She also knows when “the tank is empty” and has the courage to admit it. I also admire the First Minister of Wales, Mark Drakeford for his thoughtfulness and understanding of the issues facing patients and the health service.

What UK policy or fund is the government getting right?

Its expansion and funding of GP training places. In England, we now have more GPs in training than ever before. We need to see many more, but we also need investment to allow more training placements in GP practices. And we need to see matching efforts to keep GPs in the profession.

And what policy should the UK government scrap?

GPs know our patients best, and we want the government to trust us to do our jobs. Currently, we spend huge amounts of time box-ticking to meet quality indicator targets, which takes us away from front-line patient care, where we want to be. We want to see this significantly reduced.

What upcoming UK policy or law are you most looking forward to?  

We were disappointed when the government’s health disparities white paper was shelved, as it was necessary. We’re now expecting a Major Conditions Strategy. It’s vital this not only considers NHS treatment and diagnosis, but also the wider determinants of health that are key to tackling health inequalities, combined with targeted, engaging public health campaigns.

What piece of international government policy could the UK learn from?

Although not perfect, the Norwegian 2012 Public Health Act is a good example of health policy as it has a powerful strategy to reduce health inequalities, presenting a clear focus on reducing social inequalities and using the “health in all policies” approach. It’s certainly something we can learn from.

If you could pass one law this year, what would it be?

More policy than law, but it would be to increase the allocation of funding for healthcare, and ensure a greater percentage of it is allocated to general practice. GPs and our teams make up the vast majority of patient contact within the NHS and keep the rest of the system sustainable. We have good international evidence that countries with strong primary care systems can offer much better healthcare to patients, and reduce morbidity and mortality.

[See also: Is the BMA silencing striking junior doctors?]

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