This is the future for the next decade: fewer GPs and more distant access to all medical skills if you live in rural areas. Breakdown of many systems. Private Health options pending..

There are, according to the Daily Mail, over 10m people who are short of their normal GP service. This is an inexcusable dereliction of duty in a civilised society. Poor manpower planning, poor politics, unequal educational opportunity and standards, and poor funding are responsible, along with the decentralisation of control (devolution) in a system where doctors are free to move. Don’t forget that, as it implodes, you can go abroad for treatment.

You still have the option of private care, and as one doctor explains he knows that the queue-jump goes against everything a mutualised service stands for.

The Nuffield Trust reports on the uncertainties which will follow after Brexit. Staff shortages, drug supply chain problems, are just two. The structure of Social Care may break down as it is dependent on overseas staffing. But whatever shortages there are now will be worse after Brexit. GPs are an international commodity and can take their skills overseas. Most of the former British Empire and Commonwealth countries are also short of GPs, so there is a ready market waiting for newly qualified, or disillusioned GPs.

This temptation to move abroad also applies to consultants whose pension rules make it unproductive for them, however keen they are, to reduce waiting lists. James Phillips for Professional Pensions reports: Pensions tax issues leading to longer NHS waiting lists

The Kings Fund reports on the Health and Social Care system, and its threatened breakdown.

In my own area there is no “choice” (West Wales, Hywel Dda) so that if someone needs a “greenlight laser” they will not get referred. Older fashioned TURP (Transurethral resection of the prostate) has far more side effects and is far more intrusive, with slower recovery times. Consultants in Hywel Dda will not refer for this treatment under the Welsh Health Service, as the money would move with the patient and Hywel Dda would lose cash. There are plenty of other examples of improved care but they are always concentrated on cities, and rural citizens will get them less. In England, provided patients are prepared to wait and to travel themselves, “choose and book” (e.g. Cumbria) allows them access. This does not apply in Wales.

Yes, it would be a good idea to recruit retired GPs, and many like myself would help out, but there are issues around medical indemnity and speed, and most of us would want to see the system founded on a financial rock rather than the quicksand of today.

John Hebditch reports from Aberdeen: Warnings of GP crisis as Abderdeen GP surgery will shut its doors next week.

and also Nearly 60% plan to cut hours and 25% to leave in near future.

Retired doctors urged to relieve rural NHS recruitment crisis

North-east medical practice to close after GP recruitment issues

17 overseas medics offered jobs at Shropshire’s A&Es

150 new medical staff taken on by Shropshire hospitals trust

Call for emergency meeting on Shrewsbury GP surgery closure

Shrewsbury GP surgery closure to affect thousands

Manchester Evening News July 4th.

People across Greater Manchester say they struggle to get GP appointments; “It really is a disgrace for those who genuinely need to seek medical advice urgently”

The Nuffield Trust reports: How far do the NHS’s financial problems really go? The bottom line: Understanding the NHS deficit and why it won’t go away

I still get e-mails advertising jobs in other countries with far less bureaucracy, more clinical freedom, and less intense time pressures, and a far greater income. It is this we are competing with. The only answer is to agree with all our G8 countries that we train more than enough doctors.

Queue jumping – The view of a GP David Wrigley in the Independent 2017

Going Abroad NHS

There is still little Private Practice option in General Practice, but this will change. As delays for serious symptoms become intolerable and all the ruses the experienced use to gain access fail, Private GP, like Private Dentistry will emerge..

A Private GP or a paramedic? Paramedics to replace north Wales’ GP home visits

London GP services crisis pending… Overseas doctors will probably fill the vacancies. Watch for private GPs and Private A&E departments in the capital…

Read the damning nature of this joint report.. GP shortages …. Our very own post-code lottery.

Private Medical Insurance options… Going to get more popular? Our leaders show us the way.

A general practitioner is trying to follow the dentists into private practice – clients will initially be the retired rich, but eventually many more of us.

 

This entry was posted in A Personal View, General Practitioners, Post Code Lottery, Professionals, Rationing, 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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