GPs are angry, well at least on social media they are. Primary care is struggling under massive demand.
The Tories dangled the carrot of recruiting more GPs recently. But, the reality on the ground is that most trainees are not picking this specialty; many do not want to become Partners; and, by way of reality check, you can’t force anyone to be a GP.
There are differences between the people I meet day in, day out. I interact with GPs every day - across 80 surgeries or more - and I rarely see angry folks. In the main, they are pleasant, and keen to help. ‘Yes’, some are tired, brow beaten, and only too well aware of increased pressures, but most appreciate that they aren’t the only ones.
Anger however is more present. The system now has pushed everyone into a corner.
Yes, I am a Consultant in Diabetes, but I have been fortunate enough to hold different roles in the community beyond diabetes. Within hospitals, in unscheduled care, there are many others who are as busy as anyone else.
District Nurses, community nurses, ED doctors, AMU doctors are all being rushed off their feet. GPs are busy but so are plenty others. It’s not a monopoly on the level of busyness neither is there a prize or competition out there to win.
The system is squeezed, money is short, the politics are huge - we are ALL under pressure.
There are two perspectives on looking at this: view A is that people are well paid on a public tax funded structure, amongst the top 5-10% earners of the whole population, armed with a gilt edged pension scheme and now that the pressure is on, there are too many complaints.
Be grateful for what you have, do the hard yards, earn your pennies and retire happily. Do the job you trained to do and accept public scrutiny is more intense and get on with it.
View B, however, is that it’s becoming all too much. Extra work has descended on GPs without agreement, without resources, public expectation has been fuelled and it’s time to take a stand and say “enough is enough”. It’s time to stop doing X, Y and Z.
My view? Both views are too entrenched.
If you want more people to join GP land while at the same time saying it’s too much, then you forget the basic psychology of the generation we live in. This is no longer the Baby-Boomers or Generation X, who would grit their teeth and do it in times of pressure, we’re on to Generation Y and Generation Me.
We can criticise all we like, but for this generation work life balance is extremely important. I know lot of people turn their nose up at it - but I never ever fault anyone for that. THAT’S the world we live in - THAT’S what we have to work with - so if you want to attract more people to a specialty, you’re going to have to balance out your views.
Make it clear that it’s hard and tough - but also show how amazing GP life can be, how rewarding it can be, how much work life balance there can be.
Your present angst at the system shouldn’t result in the future being bust, should it? And let’s be honest, if GP surgeries collapse, that’s pretty much the end of our beloved “free for all” NHS.
The future path for the NHS has been outlined in Simon Stevens’ Five Year Forward View Report - does it hold the clues for the future of general practice? More importantly, is there an appetite for this amongst GPs? Can they genuinely be in charge and think beyond their individual surgeries?
I’ll revisit this in my next blog.