Quarter of GPs want to quit, BMA survey shows
BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7318.887 (Published 20 October 2001) Cite this as: BMJ 2001;323:887
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Dear Sir
Those of us who have been indicating to Government that these lights
have been at red for years take no satisfaction at all in the knowledge
that, as a maritime nation still trying to convince itself it has an
Empire, we continue to have to trawl the globe for our workforce. Thank
God for asylum-seeking and refugee doctors and nurses. It must be very
heartening for DH, inter alia, to be able to instigate the ethical
recruitment of such eager beavers, without the hassle of the traditional
accusation of poaching or asset stripping.
The irony is that these very people will be replacing those who
simply cannot stand the NHS, for multifarious reasons, not the least of
which will be the disappointment at the gap between a training designed
for diagnosis and treatment and a reality where diagnosis is often the
only fruit; the gap between the rhetoric of aspiration and the reality of
perspiration and that between sensitivity and creativity of thought and
brutalisation through systemic neglect.
Oh yes, we have our traffic lights already. The junctions are so full
of them that there is barely enough room for any vehicles on the road.
Refugees coming in and plenty going out, seeking the asylum of a portfolio
career or early retirement.
So, in true Blairite fashion, here are some more import solutions.
Firstly, all GPs across a PCO who wished to, COULD, on one Wednesday in
the month, offer only 15 minute appointments. Secondly, on one Thursday
every month, every surgery could offer only 60 minute appointments to
those patients identified by the GPs or nurses as never being afforded
enough time for a real "sort out". You would be amazed just how much you
can find out given your training and an hour - maybe even get the family
in? Thirdly, healthcare could be provided BY supermarkets (not just IN
them)through redemption of customer loyalty card points (how about a
yearly MOT or simple near-diagnostic testing?)and fourthly, why not
develop quality-assured services within the voluntary sector (New Labour
can be proud of us because that is what most of us are doing, realised, it
must be said, mostly through project start up funding at a fraction of the
cost of NHS services and so enabling the Govt to get off its statutory
provision duty of care "hook" and keep those direct taxes down).
Now, why did this particular smiling child become a cynic?
Mainly because I thought the NHS was more honest before the word "Trust"
came along.
Yours Faithfully
Dr Chris Manning
Conflict of interest: These views are personal and do not necessarily
represent the views of any organisation with which I am associated.
Competing interests: No competing interests
The BMA survey reveals the major workforce crisis facing NHS general
practice in the UK. Radical action is needed to preserve it.
· The NHS as it stands does not work, for patients or for staff.
· It is grossly underfunded and has been so for more than 20 years. The
situation now though is untenable, especially in primary care, which is
largely ignored by politicians (“schools’n’hospitals’n’police”).
· Despite this underfunding the public will not vote for increases in
taxation.
· We therefore need a new model for the way in which resources come into
the service from outside of taxation. We need a system which removes the
government from providing the funding. They should regulate sensibly and
re-imburse, but they should not fund general practice.
· I would advocate a system that is not free at the point of entry ,in
common with the systems in the rest of Europe. That is because their
systems work better than ours.
· Patients have more choice, are treated faster, and get better quicker in
most of Europe.We are now exporting patients, instead of importing ideas.
· It would then be up to the government to ensure that access was
maintained by re-imbursing the less well off on a sliding scale, or by
providing/facilitating insurance cover.
· It would free up the government to concentrate resources and time on
secondary care where the failings of the NHS are greatest, and where
politicians prefer to concentrate tax derived funding.
· It would encourage people to value the care they receive .
· It would allow GPs to regain control of their profession and allow them
to deliver the care that patients have so long wished for.It would help to
reverse the crisis in morale and recruitment revealed by the BMA GP
survey.
The workforce issue means that government must either move towards a
system based on the above principles or work out politically acceptable
ways of severely restricting access to GPs perhaps through paramedic and
nurse led primary care triage.
M D Oliver
Competing interests: No competing interests
Muddling through
Dear Dr Smith,
In my darker moments I have some sympathy with Chris Manning's views
about the NHS.
But in truth, all of us in the NHS are in the same boat: doctors,
managers and patients.
There are no grand solutions or quick fixes. Its a matter of people
at the coal face picking their way through to workable answers.
Yours sincerely,
John Hopkins
Competing interests: No competing interests