Domhnall MacAuley: Doctors behind the riots

Domhnall MacauleyWould you take a bus through the riot areas that made the news? Would you be comfortable walking along the streets that featured in the TV footage? Would you work there? Many of our colleagues do and I wonder how they are getting on with their immunisation targets, cervical smears, and QOF scores? Are all their diabetic patients well controlled, appointment systems working well, and hypertension patients queuing up for the practice nurse? Doctors working away as usual behind the riots. You hadn’t thought of that.

Every rioter’s brother, sister, mother, father, and granny has a GP. And their surgery, like every patient’s, is no more than a pram push away from their home (what a wonderful description of UK family medicine- thanks to Denis Pereira Gray). I don’t know what it is like to work there, but working in a deprived area with relatively fewer problems, I guess that for their patients, healthcare tends to be reactionary and preventive medicine is an unlikely priority. So, who are these GPs. Again, I make assumptions – but I guess they are predominantly colleagues from abroad who came to the UK when we were stuck. They probably work in less than ideal premises and struggle to get staff and locums. We were reminded last week of the environment in which they work. So, we owe them a debt of gratitude.

Have we ever thanked them? No, not quite. We criticise them for working in lock up shops, we penalise them for not reaching targets, we create a reward based healthcare system with a high proportion of performance related pay that they must struggle to achieve. We may look across the crowd at educational events and wonder why they are not there, or question their patient care from the shires and shores. The riots have made us focus on the inner city. Why get annoyed about recreational rioters, the level of punishment for facebook activists, or the so-called militant wing of materialism. Lets get indignant about how we treat our colleagues who try to provide care in very difficult circumstances; thankless and undervalued. They may not do things the way you do.  But, do you choose to work there?

Domhnall MacAuley is primary care editor, BMJ