General Practice is at a tipping point. The below letter provided by a concerned GP has been created with a view to provide a launching point for those concerned about the changes being imposed on General Practice to send to their MP to make them aware of the issues.
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Educate, communicate and back primary care.
General Practice has long been known as the backbone of the NHS – we deal with the majority of health care provision in this country, and remain, to a large extent, the gatekeepers for secondary care. We are proud of this role and believe we are well equipped for it, but not well funded or resourced. Primary care is currently given only just over 8% of the NHS budget (down from around 11.5% 4 years ago) but is responsible for approximately 90% of patient contacts with the health service. Or to put this another way, you get unlimited access to your GP, and all of your GP’s services (prescriptions, dealing with results, hospital referrals etc) for less than £3 per patient per week.
GPs have been ground down in recent years by what has appeared to us to be a deliberate media campaign aimed at undermining our previous good standing in the public eye – despite this we still remain the most trusted profession. Alongside this, the media stokes patient demand by publishing scare stories of missed diagnoses and seems to ensure that patients consult us without any thought at all of self care. This media assault has also, we are certain, contributed to an increase in spurious complaints against GPs, and a culture of rights without responsibilities among some members of the population. Studies have shown how consultation rates are increasing year on year, from around 4 per patient per year in 2000, to around 5.6 now, and steadily rising. The population is aging, so patients’ medical care becomes more complex, and increasingly this is being managed largely in the community.
Due to the above, we are struggling for survival with our current workload. Several practices across the country have already had to close due to the problems mentioned above. The profession is acutely aware of the impending retirement ‘perfect storm’ based on pension changes, revalidation and burnout along with younger GPs choosing a less stressful lifestyle abroad.
What does the current government, which is clearly aware of this situation, do to support us? Rather than urgently addressing the current crisis, it has announced plans to force us to open from 8 to 8, 7 days a week.
The funding proposed for this is £100m across the country for over 8000 practices.
To put this in simple terms, this is an increase in working hours of 60%, with an increase in funding of 1.1%. Or even more simply, for less than £2 per patient.
The announcement of this being rolled out ignores the fact that the current 20 pilot schemes have yet to deliver reductions in A&E attendances with few actually up and running as commented here. These pilots were funded with £50m, ie proportionally a much greater level of funding than that proposed for the country wide scheme.
We cannot increase the service we offer while losing new GPs to other countries where they know they will earn more and be better respected, and losing older, experienced GPs to early retirement.
To quote Dr Stephanie Di Giorgio, a GP partner in Kent who spoke at the recent RCGP conference, we are “exhausted, drowning and furious” and cannot continue functioning in the current environment for much longer.
We look forward to hearing your thoughts on this matter.