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? His answer?
Specifically, 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.’
It was five years ago that NHS bosses tried out a new scheme to reduce waiting lists. The plan offered patients a virtual alternative for traditional GP appointments, despite the fact that they were not able to access them in person.
Since then, it’s fair to say that the position of Dr Vautrey, and many of his colleagues, has dramatically evolved.
In fact, he’s spent the past six months heading up a high-profile and at times trenchant BMA campaign in favour of remote appointments.
Only last week, 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 warned them against taking on new patients.
Five years ago Dr Richard Vautrey (pictured), stated that remote appointments were a ‘absolutely no’ better than the real thing. Now, 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’
This may have caused him to feel conflicted as he has expressed reservations about these appointments in the past.
Although the demands of political battles that can be brutal can be exhausting, it was still a surprise when Dr Vautrey announced this week that his decision to leave the BMA.
The timing – Monday afternoon – of this resignation seems, at best, 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.
Sajid Javid (pictured) is putting pressure on GPs to see more people face-to-face on the back of the pandemic. He stated that patients have’stayed away form the NHS when asked to, they now want it to be seen’.
He did not mention the wider controversy over remote appointments which has made the BMA more at odds with the Government as well as patients frustrated at the fact only 61% of GP visits are currently face-toface (compared to 80% before the pandemic).
Indeed, 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.
Instead, 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 trust him. But not everyone’s convinced. Behind the scenes, there are rumours Dr Vautrey may have decided to jump ship after becoming disillusioned with more militant members of his committee and the wider BMA.
Dr Vautrey is a political centerist who lives in a wealthy suburb of Leeds with Anne, a Methodist preacher. His instincts seem to be aligned wit moderate colleagues who reportedly feel uncomfortable with the increasing hostilities between the BMA (the Government) and Dr Vautrey.
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.
Although tub-thumping political battles can be strenuous, it was a complete surprise that Dr Vautrey (pictured above) suddenly announced this Week that he had decided not to continue his role at BMA
On Saturday, 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.’
A poll on the forum that is popular with junior doctors revealed that more than 1000 members supported industrial action.
Whitehall sources say that their growing radical influence within BMA was what drove Dr Vautrey to respond hostilely in May when the Government wrote to GPs asking for an increase in 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.
‘Now, 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 advised them to not accept new patients (stock photo).
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.
Yesterday it was announced that a local medical commission had been set up. [LMC] covering members from Doncaster, South Yorkshire, 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, Lancashire, Cumbria, County Durham, and Darlington, where LMCs are also considering their position.
It is difficult, if not impossible, to reconcile their somewhat conciliatory views with the more noisy Left-wing factions within BMA.
‘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.’
The person who takes over will need 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.