GPs are heading for another historic low

GPs are burned out and fed up. Workload and bureaucracy have spiralled, pay has slumped and applications to general practice have fallen with it.

The current contract is broken, but a successor is several years away, and who is to say it will be any better? The date is October 2001.

Ten years ago, general practice was in a bad way. Morale was as low as most GPs could remember and the 2004 contract, which for a time made the profession attractive once again, was still a distant prospect. A BMA survey shocked the media by revealing a quarter of GPs planned to quit within five years. It's alarming, then, to learn that GPs today are in a worse place than during that low, with morale corroded by the assault on pay, the NHS reforms and the threat to pensions. An astonishing 35% of GPs now plan to leave within five years.

Let's not overstate the case. GPs do not suddenly hate their jobs. Of 576 respondents to our survey, only 32% are ‘somewhat' or ‘very' dissatisfied. But they do describe working lives that are becoming progressively less rewarding – as pay falls, workload rises, and general practice becomes more about spreadsheets than patient care. More than half said they were spending less time with their patients, and almost as many felt the quality of NHS care had declined.

Many GPs feel these trends are being accelerated by the NHS reforms, which have already sucked them into meetings and delivered a bewildering set of ‘quality and productivity' targets. Some 71% said the reforms had damaged their morale.

That's not a sign the profession is rejecting the chance to reshape patient care. GPs do value the increased opportunity for leadership, which was the only one of nine aspects of general practice we asked about that respondents believed had got better. There remains a desire among a section of the profession, including many of those on our GPs with influence list published this week, to take on the mantle of NHS leadership.

But there is a clear message for the Government in these results. Almost half of GPs say they are so overworked they are suffering from stress. A third do paperwork in the surgery at weekends and many are cutting down on training and study leave. GPs lack the time to do the day job, and reductions in their pay and pensions hardly incentivise them to take on any more. If health secretary Andrew Lansley expects GPs to take on new management responsibilities, he has to ease their workload elsewhere. And even then he must remember many will want to make space not for commissioning but for what they do best – looking after patients.

Many GPs are suffering from stress, anxiety and even depression as a result of their job, but they are often reluctant to seek help from others, according to a Pulse survey of GP morale.

Of the 576 GPs surveyed, 46% said they suffered from stress, with one in five suffering from anxiety and 7% from depression. In addition, 1% of GPs admitted they had alcohol misuse problems.

You can read more about our GP health survey here.