The Guardian 27th October 2015 reports the opinion of a Dr PK: Moving to Canada to work as a GP was the best decision I’ve ever made – From being underpaid and overworked I became well-paid and respected. Why would I want to return to practise in the UK? – When will the debate on rationing begin to take place?
When I read the British newspapers, in which GPs are denigrated on a daily basis, I smile at the articles that used to make me cry.
Having practised in Canada for more than a year, and having regularly discussed life with colleagues who have fled to Australia and the unfortunate ones who remain in the UK, I can say with certainty that the grass is greener for GPs on the other side.
In the UK, GPs are underpaid and overworked. After indemnity, taxes, increasingly unattractive pension contributions, national insurance and student loan repayments, most full-time GPs take home between £3,000 and £4,500 a month. While this may be significantly higher than the average salary, it is not enough to attract skilled and educated individuals into the profession, or retain current GPs. It is ludicrous that the salary of a GP should be compared with the average worker in the first place.
In Canada, and most other countries in the world, it is accepted that doctors should be paid well, command respect and be deemed essential members of the community.
At dinner parties in England, I would fear telling strangers my profession because of the inevitable barrage of abuse that would ensue. They would ask why they could never get through to their GP when they called, or why it took a week for their doctor to see them. Or worse, they would ask what GPs do in their three-hour lunch break and joke that we all just play golf.
I would bite my tongue for the most part when really my blood was boiling and the answers were on the tip of my tongue: “The phone lines and the appointments are mostly taken up by ignorant ingrates who lie about having severe symptoms to get urgent appointments because they want to be seen immediately for their minor and self-limiting ailments, for which we can do nothing anyway.
“And as for the three-hour lunch breaks, between the four home visits for patients who couldn’t possibly make their way to the practice yet are somehow able to pick up their own prescriptions, piles of paperwork, business meetings, staff meetings and checking blood and test results, I don’t have much time for golf.”
Now when I’m asked my profession at a dinner party, I proudly reply with the truth. I usually get thanked for moving to Canada and the only question I ever get asked is whether I will accept their family as my patients.
Here, I choose my hours and my patients, and I get paid fairly for the work I do. I have complete freedom to open and close my list as I see fit. Until there is a similar standard of life for GPs in the UK, those who have left will not return. Why would they?
Meanwhile, the chair of the Royal College of General Practioners, Dr Maureen Baker, has vowed to increase the recruitment and retention of GPs, and also to attract overseas doctors back to the NHS by streamlining the return process.
The RCGP has stopped overseas recruiters attending their conferences; there have been NHS adverts in the Australian industry press trying to tempt GPs and offering golden hellos of up to £20,000 for GPs to work in Leicestershire.
But so far all these efforts have proven fruitless.
There is an ongoing national GP recruitment crisis, with more than 400 training places going unfilled this year. Newly graduated doctors can see that general practice is an unattractive option and even medical school deans are warning undergraduates against second-class careers as GPs.
By freezing pay, which means a pay decrease in real terms, and promising seven-day extended hours access to GPs, the government has simultaneously scuppered its promise of creating 5,000 extra GPs by 2020 and decimated the RCGP’s drive on recruitment, retention and returners.
At a time when GP morale is at rock bottom, workload is increasing, recruitment is dropping and the exodus from the UK continues at an alarming rate, one would have thought that the career should be made more attractive, not less so.
The UK is an excellent place to learn the trade, but not to apply it. UK doctors are coveted and respected worldwide but not at home. It leads me to ask, “Why on earth would GPs return to work in the UK?”