It’s getting uncomfortable

A few months ago the BBC reported that “The poll of more than 900,000 patients found that, in the last two years, the proportion saying it was not easy to get through on the phone rose from 18% to 24%.”  The Telegraph, not a particularly pro public sector paper started an article under the headline “GP services are imploding as surgeries ‘at risk of closure'” with the paragraph

Two-week waits for GP appointments have become ‘common’, doctors have warned, while thousands could be left without a family doctor entirely due to financial cutbacks.

Then there is this interesting poll suggesting that one in ten GPs is planning to emigrate.

The Guardian rounds up our little press review with the news of falling GP numbers due to a recruitment crisis.

Since then there has been the confirmation via survey that overloaded GPs cannot cope any more and risk burnout.

I am not surprised that patients are getting upset with their GPs. For 8 years I saw a daily battle for appointments being fought  all over the East End, with long queues in front of practices at 07:30 in the morning (I recently saw a lady who brought a camping chair and her breakfast).

Over the last few years there has been a relentless onslaught on my profession from politicians and  – undoubtedly synchronised – from the usual corners of the press. The reason for this is beyond me. Primary care – as it is practiced in the UK – is the most cost effective way to deliver health care and so I naively presumed a government that has austerity as the main driver for its policy decisions would embrace and foster such a system. It’s widely recognised that ever pound invested in primary care saves 5 pounds in secondary and tertiary care, so investment into general practice is a financial no-brainer.  GPs were initially reassured that things would get better before the 2010 election after David Cameron promised  “With the Conservatives there will be no more of the tiresome, meddlesome, top-down re-structures that have dominated the last decade of the NHS“. What the nation got was the 2012 Health and Social Care Act, reducing general practice’s core funding and introducing a seven day GP service on a smaller budget.

It is getting uncomfortable in primary care, both for patients and providers. A+E is struggling like never before. If Brexit would really become a reality, then I would predict a considerable amount of EU doctors starting to think about their future in the country and the health system they love, risking another 20,000 doctors leaving (often serving areas that are struggling to attract graduates). There are about 3,000 GPs from the EU working in primary care, arriving every morning in their practice to do what they without doubt feel is the best job in the world, for patients they have been looking after for decades, in cities, towns and villages they have made their homes.

With another sudden, significant loss of doctors, the current crisis in the NHS would feel a gentle breeze, compared with the storm that’s coming, so better wrap up warm and batten down the hatches.