The ‘perfect storm’ facing general practice

Letters in The Times 8th August 2017 and the original letter sparking the response. Rationing of places has been prolonged and it’s too late to stop the two tiers of health care now… The GP situation now HAS to get worse, because if the numbers needed are imported they will not be trained for British General Practice.

Image result for perfect storm cartoon

The ‘perfect storm’ facing general practice

Sir, Elizabeth Clarke (letter, Aug 5) fails to appreciate the “perfect storm” facing primary care. With the ageing population, demand for GP appointments is steadily rising, up 25 per cent in six years. At the same time medical defence fees are rocketing and we are still expected to carry out complex consultations often involving patients with multiple conditions in ten minutes; my working day is never less than 12 hours.

If general practice were so lucrative we would have lots of eager young doctors wanting to enter the profession, but there is a huge number of vacancies in GP training posts, and retiring GPs are not being replaced, resulting in practices closing.

There is a crisis in primary care and it is catastrophic that little is being done to tackle it, with the exception of Jeremy Hunt’s plan to harvest 5,000 GPs from the “magic GP tree”.

Dr Stewart McMenemin

Sir, I was dismayed to read Elizabeth Clarke’s suggestion that GPs’ earnings are so great that they need work only three days a week. If this is the case, why are a growing number of partnerships unfilled and why are some practices declaring themselves no longer viable? After 25 years in general practice I am seeing more patients, more often and for longer, while my pay remains the same as ten years ago. Were I younger I would certainly be considering other occupations or emigrating. As it is, I await retirement.

However, ill-informed comments reduce morale still further and I seriously believe that general practice, as we know it, will shortly cease to exist. Some may believe that this a good thing. If so, the best of luck to them in their old age.

Dr Roderick Shaw

Sir, As a fourth-year medical student I was disappointed by the implication that doctors are shirking their duties to society. Even my brief experience of general practice has given me huge admiration for the way GPs cope with the stress of an emotionally draining job where one mistake, in ever-shortening consultations, could lead to someone’s death. It’s hardly surprising that some of them, both male and female, feel unable to work full-time. The vast majority of medical students are motivated by a commitment to do their best for patients, rather than personal gain, so it is disheartening to feel that there is no room for doctors to be human.

Katherine Read
Imperial College London

Sir, I am a young GP who is “part-time”. But though I see patients for just six morning or afternoon sessions, each clinical day lasts more than 12 hours, equating to 36 hours of work. There are then insurance reports and benefits assessment forms to complete, cluster meetings (these would be commissioning meetings in England) and mandatory educational meetings for my appraisal, which all takes an average of another ten hours a week. In what other profession is a 46-hour week considered part-time?

Dr Alec Jones
Llangollen, Denbighshire

Sir, Many part-time GPs, myself included, are women with young families. If we could not work part-time we would not work at all: what a great loss to the profession that would be. It is better to have a part-time GP than no GP at all.

Dr Annie Middleton
Tunbridge Wells, Kent

The original letter 5th August:

Sir, The obvious way to ensure that GPs work full-time is to pay them less. Full-time earnings for GPs are so great that most can have the luxury of a very comfortable life working only three days a week.

If they feel that their work is too stressful to work any longer, perhaps they should try some of the occupations that pay half as much as theirs.

Elizabeth Clarke

and on the same day PART-TIME GPs

Sir, I am not surprised that trainee GPs find it too stressful to work full-time (report, Aug 2). Many have or want children and many have well-paid husbands. When I was a medical student less than 10 per cent of my colleagues were female. Is it not time someone insisted on medical schools recruiting at least 50 per cent males?

Dr Tony Barson

The Training of doctors…. unfortunately it is too late to recover in even the 5 years promised by government… Decommissioning of operations

Medical Schools: your chances – applications-to-acceptance ratio was 11.2.

2,000 foreign GPs needed to tackle growing shortage. How about an apology to 20 years of rejected applicants to medical school?

The history of denial in GP recruitment: over 50 years. The result of a sustained collusion of denial.. It’s going to get worse..


Image result for perfect storm cartoon

This entry was posted in A Personal View, Stories in the Media 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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