My email exchange with ‘Andrew Lansley’

 

The following is an email exchange with ‘Andrew Lansley’ from March/April 2010; I have edited it only so that it reads ‘top down’ rather that ‘bottom up’ (when occasionally it says ‘see below’, this now means ‘see above’). Read it carefully, look also at the addressee boxes.

 ________________________________
From: Farrelly George (Tower Hamlets PCT)
Sent: 16 March 2010 10:15
To: andrew@lansleyforsouthcambridgeshire.co.uk
Cc: Farrelly George (Tower Hamlets PCT)
Subject: choosing your GP

Dear Andrew,

I am a GP in Tower Hamlets. We have recently received material from the DOH about the ‘consultation’ on the issue of being able to choose your GP without the constraints of a practice area. I am aware that you have pushed for this and that you have criticised Labour for not pushing it themselves. My impression is that this ‘consultation’ is in response to your championing this project; they don’t want to be outflanked.

My own feeling that while this idea sounds good, there are all sorts of problems that will arise if implemented.

As this is a cause which I believe you back, and would push for if in government, do you have a position paper, feasibility study, or related documentation which gives evidence that you have considered not only the benefits but also the risks of this idea, and that you understand the nature of general practice (and here I mean quality general practice)? Would you please email me whatever you have on this, or point me in the right direction.

Many thanks,

George

*
—–Original Message—–
From: “Farrelly George (Tower Hamlets PCT)” <george.farrelly@nhs.net>
Sent: Sunday, April 4, 2010 6:25am
To: “andrew@lansleyforsouthcambridgeshire.co.uk
<andrew@lansleyforsouthcambridgeshire.co.uk>
Cc: “Farrelly George (Tower Hamlets PCT)” <george.farrelly@nhs.net>
Subject: FW: choosing your GP

Dear Andrew,

I have not recieved an answer or acknowledgement of my email sent on 16 March. I am aware that you are probably very busy at the moment. Perhaps a member of your staff could reply to this.

Best wishes,

George

*

From: andrew@lansleyforsouthcambridgeshire.co.uk
[mailto:andrew@lansleyforsouthcambridgeshire.co.uk]
Sent: 06 April 2010 10:34
To: Farrelly George (Tower Hamlets PCT)
Subject: RE: FW: choosing your GP

Dear Mr Farrelly,

Thank you for your email- i would like to apologise for the delay in responding to you. Your correspondence is currently with Mr Lansley and he will be responding shortly.

Kind regards,

Ed McRandal
Office of Andrew Lansley

*

From: Farrelly George (Tower Hamlets PCT) <george.farrelly@nhs.net>
To: andrew@lansleyforsouthcambridgeshire.co.uk
<andrew@lansleyforsouthcambridgeshire.co.uk>
Cc: chairman@rcgp.org.uk <chairman@rcgp.org.uk>; president@rcgp.org.uk
<president@rcgp.org.uk>; officer-vicechair2@rcgp.org.uk
<officer-vicechair2@rcgp.org.uk>; Lister, Sam (Times); Jeremy Laurance (Independent)
Sent: Fri Apr 23 08:48:34 2010
Subject: RE: choosing your GP; 3rd request; cc to Clare Gerada, Steve
Field, Iona Heath (RCGP); Jeremy Laurance (Health Editor, Independent),
Sam Lister (Health Editor, Times)

Dear Andrew Lansley,

I am a GP in Tower Hamlets. I first emailed you about this issue (see below) on 16 March, with a further reminder on 4 April. I have not yet received a reply. I can understand that you are busy at the moment but this is a very important issue and you are aspiring to be Secretary for Health if in government. I feel that we citizens and we frontline workers have a right, nay a responsibility, to hold you responsible and accountable, to really push you on the detail. I feel that quality general practice has been undermined and eroded by Labour and its top down policy-making that is quite ignorant of what happens in the real world, without any real consultation with those who have to implement these ‘good ideas’. To compound the problem, the system (and it is vital to view this in systemic terms) is set up in a way to block or discourage feedback; if systems do not have healthy feedback mechanisms, they they do not work, they become unhealthy.

So I repeat: would you or one of your staff send me evidence that you have thought this through, have you done a realistic risk assessment? I happened to meet Andy Burnham earlier in the week when he visited Tower Hamlets; I pushed him on this. He is a nice enough man but I was not reassured by what he had to say; he does not understand the complexity of delivering quality primary care, I don’t think he realises what the unintended consequences of various ‘reforms’ have been. He has not thought through the complexity of the ‘Choose your GP Practice’  idea.

I fear that the conservatives will be no different.

I await your response. Silence is, or course, one type of response.

Best wishes,

George

The Tredegar Practice, 35 St Stephens Road, London E3 5JD

*
—–Original Message—–
From: Parsons, Jenny [mailto:Jenny.Parsons@Conservatives.com]
Sent: 23 April 2010 10:07
To: Farrelly George (Tower Hamlets PCT)
Subject: FW: choosing your GP; 3rd request; cc to Clare Gerada, Steve
Field, Iona Heath (RCGP); Jeremy Laurance (Health Editor, Independent), Sam Lister (Health Editor, Times)

Dear George,

Thanks for your email. Over the last five years we have published quite a few policy papers, most of which have an accompanying consultation. I have attached the oneNHSautonomyandaccountability which may be of most interest to you but can send you plenty more if required.

Andrew engages regularly with GPs, the LMC, the RCGP etc so I can assure you he is acting with great understanding. In fact, he is often accused by Labour of being in the pockets of GPs! One of our key policies is that GPs, in conjunction with their patients, will be given control over local healthcare in a way that Labour has simply not allowed.

Do call anytime if you’d like to discuss. Apologies if you do not hear back from me immediately – we’re working around the clock at the mo.

All the best,
Jenny

Jenny Parsons
Chief of Staff to Andrew Lansley CBE MP

*
________________________________________
From: Farrelly George (Tower Hamlets PCT) [george.farrelly@nhs.net]
Sent: 25 April 2010 17:06
To: Parsons, Jenny
Cc: andrew@lansleyforsouthcambridgeshire.co.uk; Farrelly George (Tower
Hamlets PCT)
Subject: RE: choosing your GP; 3rd request; cc to Clare Gerada, Steve
Field, Iona Heath (RCGP); Jeremy Laurance (Health Editor, Independent), Sam Lister (Health Editory, Times)

Dear Jenny,

Your document did not address the issue I originally emailed about (on 16 March, see below), which is the question of re-writing the framework for registering with GPs. I will paste the original email here:

“I am a GP in Tower Hamlets. We have recently received material from the DOH about the ‘consultation’ on the issue of being able to choose your GP without the constraints of a practice area. I am aware that you have pushed for this and that you have criticised Labour for not pushing it themselves. My impression is that this ‘consultation’ is in response to your championing this project; they don’t want to be outflanked.

My own feeling that while this idea sounds good, there are all sorts of problems that will arise if implemented.

As this is a cause which I believe you back, and would push for if in government, do you have a position paper, feasibility study, or related documentation which gives evidence that you have considered not oly the benefits but also the risks of this idea, and that you understand the nature of general practice (and here I mean quality general practice)? Would you please email me whatever you have on this, or point me in the right direction.”

*

I would be grateful for any documents on this particular issue.

Many thanks,

George

*
________________________________________
From: Parsons, Jenny [Jenny.Parsons@Conservatives.com]
Sent: 25 April 2010 17:18
To: Farrelly George (Tower Hamlets PCT)
Cc: andrew@lansleyforsouthcambridgeshire.co.uk
Subject: RE: choosing your GP; 3rd request; cc to Clare Gerada, Steve
Field, Iona Heath (RCGP); Jeremy Laurance (Health Editor, Independent), Sam Lister (Health Editor, Times)

Dear Peter,

I thought you might be interested to see the broader policy framework which we have set out for GP commissioning.

As far as practice boundaries are concerned, you are right in that we support people registering with a practice of their choice.

If a surgery doesn’t provide the service that a patient wants e.g. someone living in Bath may want to register with a surgery near their work in London but then couldn’t expect home visits, then they would register with another practice, nearer to home, where that service was possible.

I will speak to Andrew Lansley about a feasibility study. Are you responding to the Government’s consultation? If so, I’d be interested to see your response.

At the end of the day we share the same aim as you, to make the NHS work better for patients.

If you’d rather contact me direct about this please do. I’m happy for our exchanges to be conducted in this open forum, so long as your are happy for me to treat my emails to you in the same way.

Thanks
Jenny

*

________________________________________
From: Farrelly George (Tower Hamlets PCT)
Sent: 26 April 2010 10:41
To: Parsons, Jenny
Cc: andrew@lansleyforsouthcambridgeshire.co.uk
Subject: RE: choosing your GP; 3rd request; cc to Clare Gerada, Steve
Field, Iona Heath (RCGP); Jeremy Laurance (Health Editor, Independent), Sam Lister (Health Editor, Times)

Dear Jenny,

Just to be absolutely clear: you do not have documentation to show how you have thought through this issue (benefits and risks). I appreciate that there are problems for some people juggling the complexities of modern life, and it is perfectly right to think about their needs. But that is quite different than talking up a quite different approach to the provision of primary care in England (I don’t know to what extent this would apply to Wales, N Ireland, and Scotland).

My intention with this email was quite simple: to check to what extent Andrew Lansley and his team have grappled with the nuts and bolts of this, and to see the evidence. Please confirm that at present you do not have anything to give me.

I will be responding to the Government’s consultation and am happy to share my views with you (I will contact you separately about this). Everyone says they want the NHS to work better for people. What is essential is to get a sound, robust, efficient, honest methodology for going about the thinking and planning for this. New Labour have been, to my mind, atrocious with this. And I speak as one who was delighted when Tony Blair ousted the previous scoundrels.

Best wishes,

George

*

From: Farrelly George (Tower Hamlets PCT)
[mailto:george.farrelly@nhs.net]
Sent: 16 May 2010 21:10
To: RCGP Officers – President; Chairman; Officer-ViceChair2; Jeremy Laurance (j.laurance@independent.co.uk); Sam Lister (sam.lister@thetimes.co.uk);
fgodlee@bmj.com; Andreas Whittam Smith (angela.hutchins@c-of-e.org.uk);
j.dixon@kingsfund.org.uk
Cc: andrew@lansleyforsouthcambridgeshire.co.uk;
Jenny.Parsons@Conservatives.com
Subject: ‘Choosing your GP’; do politicians test their policies before
trying to implement them?

Dear Colleagues,

Some of you have been privy to part of this email chain, a few I have added now at the end. I am sending this final email out so that you will know how it ended. There is a document attachment which is the one mentioned in Jenny Parsons’ 23 April email. It does not address the issue of choosing your GP, which is what I requested in the first place.

I write as a simple citizen who happens to work as a GP. I have no political axe to grind, I am not a member of a political party. For several years I have felt oppressed by the weight of government policies which have undermined our efforts to provide good quality general practice which is sustainable. My sense is that politicians and people at all levels of the Department of Health really do not understand what quality general practice is, and that they dream up ideas which become policies without having a grasp of the practical realities. These policies then have unintended consequences. But the policy makers, again, are ignorant of these unintended consequences because there are no feedback mechanisms (indeed, feedback is blocked).

It is really an appalling state of affairs. This email concerned itself with only one issue. But the problem is that this modus operandi is generalised throughout government.

I have a dream: that the RCGP will stand up more robustly to the power brokers and challenge them; that journalists will be more probing and not limit themselves to merely repeating the briefings given to them by politicians and DOH press officers.

Perhaps the pendulum is shifting direction. I understand that the King’s Fund is about to issue a report critical of the current GP target and assessment methodology. It is about time. Perhaps the ‘new politics’ will deliver something better (I hope so) but I will watch events with a critical eye.

Best wishes,
George

2 Responses to My email exchange with ‘Andrew Lansley’

  1. Alex Gregory says:

    Good work. This looks like another example of “policy-based evidence”. They have a policy, the “evidence” will come, they just haven’t written it yet.

  2. paulonbooks says:

    I think we have our definive answer now, for this and the range of “policies”. No thought, no knowledge, no experience, no good. The Tories aren’t even bothering with Blair’s fake pilot studies – it’s full speed ahead for the iceberg.

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