A very public negotiation

Last week I suggested we were seeing brinkmanship in the NHS between ministers and GPs. Today, the next hand appears to have been dealt with the announcement that GPs can expect to see an increase in their ranks of 2,000 by 2018.

Needless to say the Royal College of General Practitioners applaud this announcement:

If we have more GPs able to spend longer with patients and communities then we can adapt to meet the needs of the 21st century.

Let's try to deconstruct the Royal College's justification. If GPs are more involved in CCGs how will they be able to spend more time with their patients? Indeed why wasn't this issue raised when CCGs were first grasped with open conflicts of interest? Are the Royal College seriously arguing that GPs are unable to adapt to the 21st century without an increase in numbers? Other public service providers are expected to adapt with lesser numbers and greater use of digital. Indeed is it not the case that there is greater self-diagnosis of potential GP door-steppers using web-based sources. Are the Royal College really justifying the case for GPs, and I assume their own longer-term negotiating power.

On the other hand, will the Department of Health question that rationale and why the Royal College haven't taken responsibility for ensuring GPs have been adapting to the 21st century? Will the DoH ask for evidence of impact? In this game of brinkmanship, surely the DoH should have used those levers earlier in the game?

However, if I was in the Royal College, I'd say thanks and wait for the next offer - DoH want CCGs to succeed and politicians will want a good NHS story as they approach the next election.

Fortunately this negotiation is appears to being played out in the public domain - we can all watch and learn.