Who wants to be a GP? Rebuiling Trust is not just needed for juniors… The NHS: How bad will it get?

Recruitment has been an increasing problem since 2001. Junior doctors shun general practice.

Recently: Now GP recruitment problems affecting patients, doctors tell MSPs in Scotland


Fears abound in the profession, and some are related to the privatisation of primary care by default. Margaret MaCartney opines Margaret McCartney: General practice is going the way of NHS dentistry (BMJ 2016;354:i4817 ) – something that NHSreality has been warning for 3 years. Undercapacity and relative rarity means that doctors in demand and willing to work may do more and more private consulting. Perverse incentives to over diagnose and over treat become greater in private services, especially where there is no independent confirmation of need.. Rationing has been by neglect, undercapacity and short termism politics: denial of the need for a victorian planning ethic…

So the government responds with (Chris Smyth September 20th in the Times): Doctors told to reveal all income from private work – NHS register will expose conflicts of interest

It seems there will be a loss of privacy and liberty for doctors, and if they do not do any private work that too will be clear. Presumably HMG will publish an “on line” index?

Out of Hours is another problem, especially with the gender bias in recruitment and a contract which is problematic: NHS out-of-hours services being run without a single doctor with some turning to refugee medics to plug GP shortage · HOLD HOLD NHS out-of-hours operates without a single GP, amid spiralling crisis

New GP training places aimed at alleviating a recruitment “crisis” facing family doctors will not be filled, according to a leading representative body.  – this is true for Scotland but also (and more so) for Wales 30% vacancies and the N East (40% vacancies).

Walesonline reports: Everything you need to know about the shortage of GPs in Wales · (10 days ago)

A 2015 map showing closed GP practices in Wales

A map of recently closed GP practices in WalesThe Royal College claims more than 400 full-time-equivalent GPs are needed in Wales by 2020 to deal with a looming “crisis” in the profession.



Dr Tom Black opines in The Belfast Telegraph 29th September 2016: Bedrock of NHS is on life support and fading fast – Without major surgery by the Executive, NI general practitioner service doomed, as is health service, claims Dr Tom Black#

Henry Bodkin in the Telegraph reports 30th September 2016: Anti-GP ‘banter’ hindering recruitment into general practice, top doctor warns

Trust is disappearing, both in junior doctors and GPs. In 2004 the BMJ published: Rebuilding Trust in Healthcare; What is the Real Cost of More Patient Choice?; Patients, Power and Responsibility: The First Principles of Consumer-Driven Reform (BMJ 2004;328:54 ) and things have got worse since. Tom Moberly (editor) repeats the statement 17th September 2016: Rebuilding Trust

Nick Triggle for BBC opines 30th Sept 2016: The NHS: How bad will it get?

Dr Tom Black in The Belfast Telegraph 28th September 2016: GPs in Northern Ireland urged to hand in resignation letters over ‘escalating crisis’ in primary care – The British Medical Association says the Department of Health needs to take urgent action to save general practice



This entry was posted in A Personal View, Rationing, Stories in the Media, Uncategorized on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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