‘Sugar and Spice’ – are GPs just moaning?

On his blog, Partha Kar suggests that GPs are not unique in the pressures they face, and perhaps they should do more than just complain on media such as Twitter. My reply to him is as follows:

You make several good points in this piece, but also miss several more.

Firstly, I fully accept that the entire system is under huge strain. I am a GP, and my wife is a community nurse; I know how stressed and overloaded she and her colleagues are. Similarly, my many close friends who work in secondary care look as overrun as I do when I see them. However, the difference between general practice and other parts of the NHS lies in how general practice is funded. Because of our unique status as ‘independent contractors’, GP partners are the only part of the entire system who have taken personal pay cuts to keep the system alive. I have personally lost about 20% of my income in the past four years, and that’s before allowing for inflation. The last time I had a ‘pay rise’ was 2005.

Sugar cubes

Secondly, I fully acknowledge that the new generation of doctors is not the same as mine (those in their mid-50s). I see very few, male or female, who are prepared to work the long hours that I have always regarded as a normal working week. There are several consequence of this for all parts of the system. Far more individual doctors will be required than those who retire in the next few years. Just as importantly, we need to find a new generation of leaders amongst young doctors to help define the future shape of healthcare, because it is certain that we cannot simply continue as we have done in the past. Just as the attitude of younger doctors is very different from that of older doctors, so the attitude of society is very different. The growing ‘consumerisation’ of healthcare throws up its own challenges – it seems to me that the ethos of the ‘old’ NHS based upon providing care for those who need it is unsustainable when wants are regarded as having such great value, and we will need articulate doctors in all parts of the system to tell everyone – patients, politicians, and the press – some uncomfortable truths.

Old spice front

And GPs are not just sitting back and moaning about their woes. Some of us have decided to take action. From very modest beginnings, Resilient GP has developed in the past few months to try to offer younger GPs the chance to be mentored after their higher training is complete. We have organised our first courses, provided some one-to-one mentoring, and intend to build further on this in the coming year. By doing so, we hope that we will develop the future generation of leaders that the profession needs. We are also looking at sustainable ways of developing vertically integrated community-based care, to provide a higher standard of care for patients in a manner that is more sustainable for all healthcare professionals.

Rather more than 140 words, but this is an important topic and worthy of a proper response.

Prit Buttar