I seem to have touched a nerve with my article about the new GP contract – especially as information released subsequently shows the situation is getting worse.
According to the BBC – using numbers from the Nuffield Trust – the number of doctors working in general practice has gone into a “sustained” freefall, for the first time in 50 years:
“The NHS is seeing the first sustained fall in GP numbers in the UK for 50 years, the BBC can reveal.
“An analysis by the Nuffield Trust think tank for the BBC shows the number of GPs per 100,000 people has fallen from nearly 65 in 2014 to 60 last year.
“There have been reports of waits of up to seven weeks for a routine appointment, while those needing urgent appointments have been forced to queue outside practices in the early morning to guarantee to be seen.
“One in three junior doctors who accept places on GP training courses, drops out of the system, according to the Nuffield Trust. Meanwhile, the numbers retiring early have been increasing. Two-thirds of retirements by GPs come early – double the rate seen just five years ago.
“The BMA said doctors were being asked to work longer and harder, without recognition or an increase in pay. Dr Richard Vautrey, of the BMA, said workloads were now “unmanageable” for many.”
Another survey, carried out by Pulse magazine for the BBC’s Panorama, showed that those GPs who are left are being forced to see almost double the number of patients they should, while working 11-hour shifts. This means they are openly making mistakes that could put patients at risk.
The Independent stated: “GPs are working an average 11-hour day, including eight hours of care and three hours of paperwork… On average, each GP dealt with 41 patients per day, despite saying 30 was a safe number. One doctor in 10 dealt with 60 or more patients a day – double the safe limit.”
The article quoted one doctor who said as well as patient demand, there was a “workload dump” from secondary hospital care: “This workload creates patient safety risks. There are risks around having multiple patient notes open because we’re helping a nurse out with hers, or we’re 30 minutes late so we see the next patient while finishing the notes of the last.
“We might forget consultant details, plans and actions, or prescribe for the wrong person, use the wrong labels on blood tests, and so on.
“I have raised safety concerns with governing bodies before. I was basically told to shut up or my practice would be run over with a fine-toothed comb.”
And the piece mentioned a report in March from the King’s Fund, Nuffield Trust and Health Foundation predicted that GP shortages in England will almost triple to 7,000 by 2023-24. It said the government would miss its target to recruit 5,000 more GPs by 2020 and the only way to cope with the growing workload was to put more pharmacists and physiotherapists into GP practices.
This seems to support the new GP contract and the idea of creating “primary care networks” on a US-style model, with less-qualified staff seeing patients, meaning confidentiality is lost and it will be almost impossible to see a genuine doctor.
Primary Care Commissioning, an organisation which seems dedicated to the creation of these networks, is running a series of podcasts about what it does – which will undoubtedly present a rose-tinted view that would shame any skilled diagnostitian. Here’s the first:
Before you start thinking these new PCNs don’t sound so bad, bear in mind that the government has overseen a fall in the number of nurses available to the NHS, as well. Here’s a short Twitter thread about it, prefaced by Dr Jacky Davis, co-editor of NHS:SOS:
Complete madness to have driven out the nurses that we’ve got because of #brexit and intolerable work pressures
Unforgivable/immoral to take nurses from parts of the world that can’t do without them
RT if you think this govt couldn’t organise a piss up in a brewery https://t.co/lGMOrKNl1T
— Jacky Davis (@DrJackyDavis) May 8, 2019
Ben Bradshaw has just raised the issue of this emergency recruitment in Parliament.
Cat out the bag now.
— Nick🇬🇧🇪🇺 (@nicktolhurst) May 7, 2019
Meanwhile, in Prime Minister’s Questions, Theresa May had the front not only to claim that there’s nothing wrong, but also to lie that her government was giving the NHS its largest injection of cash in history: “It is this Government, with their long-term plan, who are ensuring that we give that care to staff. NHS staff work hard, caring for patients, and this Government will care for NHS staff. It is only because we are able to give the NHS its biggest cash boost in its history and to give it that long-term plan that we will deliver for NHS staff.”
Labour leader Jeremy Corbyn put her straight: “Under the last Labour Government, NHS investment rose by 6% a year, but under this Government it has barely reached 1.5%. Five thousand nurses and midwives from European Union countries have left the NHS in the past two years, and there are 100,000 staff vacancies across the NHS in England alone.
“Nobody on this side of the House ever talks down the NHS—it is Labour’s greatest achievement. The principle of healthcare free at the point of need as a human right was a Labour achievement, and every Tory MP voted against it.”
But the Conservatives currently have control, and are re-modelling the NHS in England to make it resemble the private, American model into which they want to sell it.
What are you going to do about it?