General practice in decline

Instead of fixing Britain’s unprecedented GP shortage, Jeremy Hunt has buried his head in the sand, argues Martin Edobor 

At 7am my daily morning ritual begins. It ends with a quick fruit over BBC morning news and a check to ensure I have my stethoscope and ID badge. Today I arrive at the health centre to learn the morning clinic is overbooked. I have 20 patients to see before lunch, with 10 minutes or less allotted to each patient.

Ten minutes is a very short length of time to gather a history from a patient, perform an examination and make a diagnosis; yet this is the reality for many GPs. These tough working conditions, coupled with a lack of resources due to underinvestment, are among others a reasons GPs are experiencing burnout.

The average waiting time to see your local GP is around three weeks and this is about to worsen. One in five GPs is planning to leave the National Health Service within five years, according to a recent survey by GP magazine ‘Pulse’. This will have a devastating effect on primary care and the wider service. The survey further reveals that many of the GPs who are planning on staying plan to work part-time.

This problem is not new. Prior to the 2015 general election the NHS already had an unprecedented GP shortage. Health secretary Jeremy Hunt promised to recruit 5,000 new GPs. Two years on we see no clear signs of this pledge ever being achieved. Waiting times to see a GP continue to rise, the shortage remains, and Hunt continues to bury his head in the sand.

General practice forms the backbone of our NHS, acting as the gateway via which the public can access essential specialist services, such as ophthalmology and neurology. GPs are the first point of call when you fall ill, and are often the clinicians who spot the initial signs of a life-threatening illness.

GPs are the doctors who care for you from cradle to grave, and frequently act as a social safety net for many older patients, performing home visits for the most vulnerable. If we operate an under-resourced primary care system with too few GPs, it will only be a matter of time until this essential service buckles under the weight of growing pressure.

The government needs to take urgent action. The Conservatives must introduce measures to stabilise general practice and stem the potential exodus of GPs. In May the Doctors’ union, the British Medical Association, attributed lengthening waiting times and lack of resources in general practice to a funding deficit it estimates to be at least £2.5bn. The BMA called on all political parties to commit to increasing general practice funding in England by at least 11 per cent.

The BMA further posit that the government must make general practice a more attractive career option for doctors. This could be done by ensuring that GPs remain at the centre of delivering primary health care through maintaining their independent contractor status. The government should introduce a national standard for a maximum number of patients that GPs and other primary care professionals can manage in a working day. The BMA believe this should be set at a level which allows for 15 minutes or more for a patient to be seen. Bureaucracy should also be reduced, so that GPs spend more time caring for patients.

I chose to pursue a career in general practice because I wanted to treat patients and provide high-quality clinical care. However, GPs are currently working in an increasingly turbulent and under-resourced environment. Hunt and the Conservative government must deliver on their promise of extra resources if they are to prevent a terminal decline in general practice.

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Martin Edobor is a junior doctor specialising in general practice and a member of the Fabian Society health and care group. He tweets at @martinedobor

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Comments: 2...

  1. On August 4, 2017 at 7:33 pm Michael Crouch responded with... #

    Given Hunt’s failure to stem the GP exodus since 2015, can we take seriously his recent plans for recruitment in the mental health professions?

    Many GP surgeries are increasing the workload of nurse practitioners in triage and treatment. One wonders if this will be the route the Tories take out of this, and what the ramifications will be if they do.

  2. On August 5, 2017 at 7:11 am John responded with... #

    One of the problems of the NHS and general practice was the Bevan compromise. This enabled them to retain independent practitioner status. This “right” is denied all other employees of the NHS including all secondary care clinicians. Surely the time has come to review this arrangement which means that there is a marked difference in the management of GP,s from all other groups in the NHS. The GP,s in the recent past have been very careful to maintain numbers on the low side and thereby strengthen their bargaining power. This has led to an inbalance between primary and secondary care. Surely the system should be managed as a single structure.

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