Having returned from Oz after 5 yrs there(bloody wife didnt like the heat!!), I can categorically say that GP dom in the UK is utter s*** compared to Oz. And I was working in bulk billing ie state funded practice. I can't think of a single thing that was worse in Oz as a GP.Not one.
No-one from Chindia, Europe or anywhere else in the goddamned world wants to come to the UK to do medicine anymore, especially not GP.. and neither should they.
To anyone who can, get out now whilst young,go Canada, Australia, NZ whilst you still can and NEVER EVER COME BACK.
Our society and the "medicine" we are forced to practice is completely FUBAR in the UK.
Rotten to the core and totally without anchor or purpose.
The farcical mess of Brexit is a apt monument to the utter moral bankrupcy of our politicians, media and "the great British public".
And if GPs want to survive or do anything to change it, we all have to leave the NHS and go completely private as did the dentists years ago. Stop expecting and hoping and pleading like pathetic victims praying that people will listen to us and do the "morally right" thing like have a properly funded service,an accounatable GMC, fines for DNA appts, jail terms for abusive patients, lifelong bans on registering with any GP service , compulsory fee attendance at forensic medical services instead, manned by police for serial offenders/serious abuse etc..
When the F*** are we going to wake up and tell "them" to shove their glorious NHS up their a**???
Oh how they must be laughing at the howls of protests..
Their strategy is clear.
Force UK GPs out by making life unbearable to create a "crisis".
Sell off the primary care contracts to rich and powerful friends who set up corporate ownerships of several practices..eventually merging into 2-3 large players nationwide.
Cartel is established.
Employ underpaid unlimited numbers of Drs from poorer countries on temp visa and contracts to "solve the crisis". Low wages etc for all.
Many in fact will be remote consulters via Babylon App services.
Rural areas will be without any physical GP within 100 miles.
Makes me sick.
Should make everyone angry and want to fight back.
But the BMA/RCGP etc will "discuss it with government".
Because "one needs to be reasonable, doesn't one"
God this country needs a revolution.
Or an enema.
It's all BS and the attempt at reductionist flowchart medicine. Patients fundamentally want to see a doctor who can assess and decide on treatment, taking responsibility fully for that because of experience.
But no-one wants to pay for it.
Or trust GPs with things like god forbid, the knowledge to order CT/MRI etc.
So we have this BS.
And we are now the laughing stock of the developed world.
Who still believe that a doctor is more than a referral monkey , flowchart or a f*****g smartphone App.
We are alone in the UK with our misguided descent into daily medical vacuity.
Takes guts and alot of patience and resolve to achieve such an outcome.
And its a great ad for working not with the worried well of leafy suburbia(Charge'em) but with the unworried very unwell of decayed urban UK.
We actually need to go back to personalised lists. We need the staffing and financial power to enable that.OK -minor illness doesnt require it. But he wheel doesn't need re-inventing. Jesus H. It's not rocket science.
Patients who come to see you trust you. You trust them.
They usually like you. You usually like them.
You forgive them their foibles and they yours.
The ones who don't like you go away and see someone they do like and both of you are happy.
Some GPs are good with heartsinks, others with worried well, others with the elderly or gynae or DM or whatever. Each to their own skillset.
Having to deal with everyone all of the time pleases no-one -all of the time.
Learn from other countries. Ditch the us and them mentality. And forget the USA which is always hauled up when anyone suggests anything different.
I have no issue with private practice. But it should be 100% private, self funded and like all real businesses, it should rise and fall on its own merits. No bailouts. No extra funding from local health trusts. No fee paid by the NHS for "registering" new patients and growing your list size to sub 40,000..PATIENTS PAY THE FULL COST OF EVERYTHING. For the NHS, what we need is a system that pays GPs for the amount and complexity of work they do on a daily basis..not some global sum, not some pool of cash split between partners where one is seeing 40 patients and the other is at some skive off LMC meeting for the afternoon. We need payment per item of service.. as they have in Australia where the GP morale is second highest only to Norway.For good reason. One is truly self employed. Work as hard or as easily as you want with all the security of a salary/partnership in many ways..but with none of the bull****. No appraisal, no revalidation..medical bodies that actually stand up for their members and take no nonsense. Why do we pay the GMC? Why do we pay the BMA or the RCGP? They have done NOTHING to protect Drs interests and what we see now is the sad result or our apathy and division, our utter feeble minded grumbling that allows our "betters" to make decisions for us.
MAD JOHN, Consultant of the Absurd(and new NICE approved UK sub speciality)