NHS England’s Director of Primary Care (and Deputy Medical Director), Dr Arvind Madan, has announced his resignation in the wake of a backlash against comments he made regarding the reorganisation of general practice provision.
Dr Madan was already under pressure for the insensitive tone he took in an interview on Friday, in which he criticised those complaining about the closure and consolidation of smaller GP practices.
These closures are in accordance with NHSE’s Five Year Forward View (published in 2014 and updated in March 2017) which seeks to modernise primary care, increasing preventative intervention at this level to reduce pressures on hospitals within the framework of Sustainability and Transformation Partnerships. The aim of this programme is to improve efficiency by consolidating smaller GP practices, gaining the cost and flexibility benefits of scale, and allowing better integration of specialist services (e.g. mental health) with larger GP ‘hubs’. However, while the closure of smaller practices may raise overall efficiency, there is a risk that it leaves smaller communities without easy access to a local practice.
Over the weekend it emerged that Dr Madan had posted a number of anonymous comments to a doctors’ forum, voicing further criticism. The comments were traced to Dr Madan after he accidentally used his anonymous account to respond to a publicly posted article.
Amid anger from the profession, and a letter from the BMA demanding action, Dr Madan announced his resignation. The incident highlights the strength of feeling within general practice about the pressures placed on it, and amongst patients directly impacted by the changes.