When I started work as a GP I did 9 sessions working Monday to Friday in routine surgeries with one half day exchanged with my partner. We also covered our own patients in the evenings and at weekends. and we delivered 50-60 babies per annum. After a few years the doctors combined in an Out of Hours rota (OOH) as a co-operative which was run from the local hospital. This was the high point of my on call career, with cooperation and teamwork three doctors could cover 120,000 people when formerly there had been 30 doing personal on call. The OOH system was demobbed, and the new “Blair” contract allowed us to opt out of OOH. By now many of the newer GPs had young families, and the benefits of no OOH were obvious. The cost of running OOH with locums became too much and salaried posts were created. Nowadays we have too few doctors and paramedics covering vast numbers of patients and in the rural locations vast areas.
Meanwhile, since Mr Blair’s new contract, the working day has become more intense. GPs often don’t stop for lunch, or coffee breaks, and engineering time for their own health or families is hard. A 12 hour working day is commonplace. More than this, the shape of the job has changed. Where I had flexibility in 1979 and could do other things at times during the day, there is now no time flexibility, and 10 hours fixed to a computer screen is unhealthy, and leads to sarcastic patients who expect and complain more….
Rationing places in Medical School means 9 out of 11 have been disappointed for years. Now Portsmouth is the first city to implode, and its going to get worse.. It takes 10 years to train a GP…
Only one in ten trainee GPs wants to work full time, according to a survey that raises fresh fears of a shortage of doctors. The average family doctor-in-training wants to work three days a week, saying the job is too intense to do a full five days.
Waiting times are already lengthening and health chiefs fear that a national GP shortage will be worsened as younger adults shun the long-hours culture of previous generations.
One in five junior doctors training to be GPs also says they do not expect still to be working in the NHS in five years, according to a survey by Pulse magazine of 310 trainees. Doctors are planning either to move abroad or to change career, according to figures that cast further doubt on government pledges to recruit 5,000 extra GPs by 2020.
Officials are trying to recruit 2,000 doctors from abroad after numbers in the NHS dipped despite rising demand from an older, sicker population.
Simon Stevens, head of NHS England, has pointed to an increase in GP trainees as an encouraging sign, but only one in ten surveyed wanted to work the eight half-day sessions considered full time, with a further tenth willing to work seven sessions.