GUY ADAMS: First he backed face-to face appointments, then called them a ‘treadmill’. Now he’s mysteriously quit as the BMA’s GP union chairman… So did Mr U-Turn jump – or was he pushed out by militant doctors?
Shortly before he became chairman of the British Medical Association’s powerful GPs committee, Dr Richard Vautrey was asked whether so-called ‘remote’ appointments were as effective as the real thing.
His answer? 絶対違う.
具体的には, he told this newspaper, he wouldn’t feel happy diagnosing a common condition such as fatigue over a webcam, or via a screen.
‘The visual clues would be hard to pick up,’ was Dr Vautrey’s verdict. ‘When you’re not there in person you don’t see the body language which tells you when a patient really wants to talk about something else.’
That was five years ago, when NHS bosses were testing out an innovative scheme that aimed to cut waiting lists by offering patients a virtual alternative to traditional GP appointments (in the face of a somewhat sceptical medical establishment).
それ以来, it’s fair to say that the position of Dr Vautrey, and many of his colleagues, has dramatically evolved.
実際には, he’s spent the past six months heading up a high-profile and at times trenchant BMA campaign in favour of remote appointments.
先週だけ, he described Health Secretary Sajid Javid’s £250million plan – launched in response to a Daily Mail campaign – to restore access to surgeries and face-to-face appointments in the wake of the Covid pandemic as a ‘bully’s charter’.
Doctors should ‘not feel pressured to return to a traditional ten-minute treadmill of face-to-face consultations’, Dr Vautrey wrote in a letter to GPs. He also urged them not to take on new patients.
Five years ago, Dr Richard Vautrey (写真) said remote appointments were ‘absolutely not’ as good as the real thing. 今, only last week, he described Health Secretary Sajid Javid’s £250million plan to restore access to surgeries and face-to-face appointments in the wake of the Covid pandemic as a ‘bully’s charter’
As a man who has previously expressed sensible reservations about those very appointments, this may have left him feeling conflicted.
Yet while the demands of tub-thumping political battles can be gruelling, it was nonetheless a complete surprise when Dr Vautrey suddenly announced this week that he had decided to quit his role at the BMA.
The timing – Monday afternoon – of this resignation seems, せいぜい, very peculiar indeed.
For it came on the very day when the BMA (in effect a trade union for doctors) escalated its row with the Government by sending out ballot papers to GPs asking whether they would support industrial action to reduce their ‘unmanageable workload’.
In his resignation announcement, Dr Vautrey made no mention of this high-profile ballot, which revolves partly around proposals for GPs earning over £150,000 to be identified, and the naming and shaming of practices that fail to improve face-to-face access.
サジド・ジャビド (写真) is putting pressure on GPs to see more people face-to-face on the back of the pandemic. He said patients ‘stayed away from the NHS when they were asked to, they now want to be seen’
Neither did he reference the wider row over remote appointments, which has placed the BMA increasingly at odds with not just the Government but also patients frustrated at the fact that just 61 per cent of GP appointments are currently face-to-face (compared with roughly 80 per cent before the pandemic).
確かに, like a striking number of the BMA’s recent PR statements, the announcement contained only a fleeting reference to the interests of the taxpaying public that GPs are supposed to serve.
代わりに, Dr Vautrey claimed that it was simply the ‘right time’ to step aside, after four years in the role, so that a ‘new chair and team’ could be installed in time for negotiations over a new five-year NHS contract with GPs scheduled to begin next year.
We must take him at his word. But not everyone’s convinced. For behind the scenes, there are rumours that Dr Vautrey actually decided to jump ship after finding himself at odds with more militant members of both his committee and the wider BMA.
Dr Vautrey is a political centrist, who lives in a prosperous suburb of Leeds with his wife Anne, a Methodist preacher, and his instincts are believed to be aligned with moderate colleagues who have reportedly felt uncomfortable with the growing hostility between the BMA and the Government.
Only last month, the Health Service Journal was predicting that heads such as Dr Vautrey’s might soon roll.
‘Mood music from the BMA’s GPs committee suggests its more moderate leaders, who seek to reconcile their profession’s anger with the mood of the public, politicians and Press, may soon be toppled after this latest furore,’ it reported.
The author of that article, the Journal’s deputy editor Dave West, said yesterday that while the exact cause of Dr Vautrey’s departure has not been confirmed, he suspects it is linked to internal tension within the BMA.
‘I think it is very likely that as a relatively moderate and sensible GP leader who has tried to work with NHS England and the Government, he was either informally pushed out (ie told he would be voted out) by other members of the BMA GPs committee, or it was made impossible for him to carry on because his views on the course of action were being overruled by other members,’ Mr West said.
While the demands of tub-thumping political battles can be gruelling, it was nonetheless a complete surprise when Dr Vautrey (写真) suddenly announced this week that he had decided to quit his role at the BMA
土曜日, to this end, it was also reported that a ‘splinter group’ of radical Left-wing doctors is now planning to ‘take over’ the BMA and ‘force it to call a strike’.
In an online forum leaked to The Times newspaper, leaders revealed that they have built a website to co-ordinate how supporters should vote in next year’s BMA elections.
‘Can we take over the BMA? Serious question!’ wrote one. ‘Given that current leadership clearly does not want to strike, is there anything we can actually do about it? I’m starting to think we can.
‘We clearly have numbers and we want the same thing. I think if we translated that into re-joining to vote in elections, and used our numbers, we could purge these losers.’
An online poll on the forum, which is popular with junior doctors, revealed that more than 1,000 members were in favour of industrial action.
Whitehall sources believe their growing radical influence within the BMA was what encouraged Dr Vautrey to respond with hostility in May when the Government first wrote to GPs asking them to start increasing the number of face-to-face appointments.
‘I think a lot of GPs have been let down by their leadership,’ said one. ‘If they had been a bit more thoughtful from the start, for example by saying that it would be difficult but they’d do their best, it would certainly have avoided the escalation of this row.
‘Instead they have raged against the Government, and the media, and patients who just want to see a doctor, and decided to carp about it all being some big vendetta or conspiracy.
「今、, instead of being involved in sensible negotiation, they find themselves in a row where it’s impossible to be radical enough for the most trenchant members.’
Doctors should ‘not feel pressured to return to a traditional ten-minute treadmill of face-to-face consultations’, Dr Vautrey wrote in a letter to GPs. He also urged them not to take on new patients (ストックイメージ)
Dr Vautrey doesn’t just face extreme pressure from the Left, either: there is also a substantial faction of centrist GPs who believe the BMA is being too confrontational – rather than not confrontational enough.
On this front, it emerged yesterday that a local medical committee [LMC] covering members from Doncaster, サウスヨークシャー, had decided to publicly oppose the BMA’s proposed industrial action.
In a letter to local practices obtained by the medical news outlet Pulse, its chief executive, Dr Dean Eggitt, said any militancy was ‘likely to harm negotiations rather than help’.
‘We need to have trusted and respectful relationships between leaders of our profession, NHS England, and the Government. We do not currently have this,’ the letter read. ‘It is our current belief that the motion from [the BMA GPs committee] and the ballot for industrial action is likely to harm negotiations rather than help, resulting in Government policies that will alienate general practice from the NHS family.’
The views of Dr Eggitt, who said he does not believe ‘any form of industrial action at the moment is warranted’, appear to be shared by colleagues in Lincolnshire, ランカシャー, Cumbria, ダラム州, and Darlington, where LMCs are also considering their position.
Reconciling their relatively conciliatory views with those of the increasingly noisy Left-wing factions within the BMA is at best tricky and at worst impossible.
‘It’s a nightmare, because whatever you do, it’s impossible in the current environment to make everyone at the BMA happy,’ said a supporter of Dr Vautrey. ‘I think Richard, who isn’t a particularly confrontational bloke, basically came to the conclusion that he’d served his time and wasn’t really enjoying the job any more.’
Whoever takes over will need a thick skin. For regardless of how their dispute with the Government plays out, the trade union that represents Britain’s family doctors must also now fight a civil war.