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Gold, incentives and meh

Tens of thousands of GPs on brink of early retirement, BMA finds

A major BMA survey has revealed that six in ten GPs are considering early retirement and more than half say their morale is either ‘low’ or ‘very low’, in findings that will form the core of the profession’s fight back against Government cuts to general practice.

The survey, which involved 420 GP respondents, also revealed that almost half the respondents having already made changes or planning to make changes to their work life balance.  

GPC chair Dr Chaand Nagpaul said he would use the ‘shocking’ results to lobby ministers on the impact of the ongoing drive to keep patients out of hospital, and highlight how funding cuts are threatening to overwhelm general practice.

A separate RCGP poll of patients showed almost two-thirds of respondents believe the sheer volume of consultations taking place are a threat to patient care. RCGP chair Dr Maureen Baker said over the weekend that general practice is in real danger of ‘extinction’.

Pulse recently revealed that GPs in some parts of England are currently working for free as a result of the changes made by the imposed 2013/14 GP contract, and a series of below inflation pay uplifts. The 0.28% pay uplift for 2014/15 has also reduced the morale of GPs.

The survey, which the BMA said is accurate to within 3.3% at a 95% confidence level, found that 56.8% had considered retiring early, while 27.7% had thought of leaving the profession.

Furthermore, 47% said they had already made changes, or are in the process of planning for a change to their work life balance. Only 14.1% said they had not considered a move away from their current role.

When asked how they would describe their current level of morale, 39% answered ‘low’, and 16% said ‘very low’. Only 1% said it was ‘very high’, while 13% said it was ‘high’.

It also found that 54.1% of GPs described their current workload as ‘unmanageable or unsustainable’.

Dr Nagpaul said general practice was in danger of becoming ‘overwhelmed’.

He told Pulse: ‘It is shocking that so many GPs intend to retire early. The Government has to act to retain the workforce – by making the workload manageable and providing enough resources. GPs are overstretched and overwhelmed, and there is not the capacity to deal with the volume of work that is moving out of hospital.’

Dr Nagpaul added: ‘We are seeing morale dip to a level that I cannot remember in my 25 years as a GP.’

One survey respondent, Norfolk-based GP Dr John Harris-Hall, said of his decision to retire early: ‘The increasing demand and workload pressure are leading to low morale and stress, causing many GPs like myself to leave the profession. I am sad to retire early but I feel there is no other choice. Enough is enough.’

The RCGP poll of 1,007 patients found that 62% believe that the number of patient consultations GPs conduct each day – which the RCGP estimated at between 40-60 in most cases – is a threat to the standard of care they can provide to patients.

The poll, conducted by ComRes, also found that 28% of those surveyed could not get an appointment in the same week when they last tried to book an appointment.

Dr Baker said: ‘General practice as we know it is now under severe threat of extinction. It is imploding faster than people realise and patients are already bearing the brunt of the problem. This will only get worse unless urgent action is taken to redress the huge and historic imbalance in funding.’

Related images

  • Dr Chaand Nagpaul 2013 - online

Readers' comments (134)

  • Why do so many post anonymously is it fear no u Coles

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  • Una Coales

    Albert, the NHS has bred a culture of fear among clinicians. I have received emails from bullied NHS hospital consultants. It is all too common for the clipboard phenomenon to be used against any clinician, nurse, consultant, GP trainee or GP, who dares speak up against injustices, workplace bullying, patient safety.

    I have seen a consultant urologist live in fear he will lose his house as he won his employment tribunal but is left with 6 figure barrister legal fees.

    I have seen a UK GP trainee bullied and threatened with GMC referral if he failed his ARCP panel appeal of his outcome 4 release.

    Many remain anonymous because they fear malicious complaints, threats of libel or litigation or God forbid a GMC referral.

    Once we accumulate a critical mass of brave clinicians who have no fear and we have brilliant legal employment lawyer back up, then will clinicians speak freely by name.

    From what I have seen of private lawyer Raj Chaudhary and the legal help he has provided for a GP trainee. I would highly recommend any GP trainee facing an outcome 4 release, to get in touch with him or insist on a BMA lawyer. Sadly I am told that Niall Hermiston is the BMA lawyer for trainees in Scotland and that those elsewhere may be allocated a regional advisor instead.

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  • Had enough of daily pile of rubbish from DOH (as good as Daily Wail)and now ready to say goodbye with a job overseas. I wish I could run a Ferrari at cost of second hand polo with a feel of Ferrari somehow and tell that to the public.

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  • I am a GP in SE London and have been very actively involved in fighting the attack on the NHS. During this time I have been part an independent documentary project which tries to give a clear narrative on the stealth privatisation. It has been a steep learning curve with the realisation that our Governments have been betraying the public interest. Handing over a well performing cost-effective single payer tax-funded system to corporate interests.
    Demoralising NHS staff is a key tactic in this betrayal. Contraction of public provision and creation of a crisis of care is designed to lead to a middle class exit to private insurance, leaving skid row services for the rest. We all end up paying more for health care as transaction cost will spiral up (5% 1990, 15% now, 30% projected with US insurance model)
    Trust in doctors will collapse as we have been set up to take the blame, being in 'the driving seat' via CCGs. In reality we have the power to decide only where the axe will fall as budgets are deliberately restricted.
    Too many on the BMA have fallen for all the bogus reassurance from Lansley and Hunt, time and time again. Naïve or complicit, take your pick. No matter, as those responsible are close to the end of their careers or look forward to some other reward. The need to go for all our sakes.
    As for those who believe in the NHS and want to fight for it, we must wake up to the reality. Primary care is being prepared for corporate takeover. Many principals will not think twice to sell up their large 'federated' practices to the highest bidder and leave their salaried colleagues to endure corporate management with even less freedom to speak up about poor care.
    Please watch the documentary trailer on:
    Read 'The Plot against the NHS' by Leys and Player
    Read 'NHS SOS' by Davis and Tallis
    Please use your BMA ballot paper to elect those who have acted to defend colleagues and patients alike.
    I am standing for election as are the following:
    Allyson Pollock, Jacky Davis, Kevin O'Kane, David Wrigley, Beth Banks, Jonathon Coates, Rosemary Scott.
    Thank you.

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  • The issue is ideology.

    If you are proNHS - you are by definition attached to the NHS contract.

    As the BMA, RCGP, GPC etc are proNHS they can not tear up the NHS contract. They can only plead for fairness on T&Cs.

    The government 'holds all the cards' and really can do whatever they want as hold the 'cash' and decide the T&Cs. Politicians have skillfully portrayed the profession as lazy and greedy i.e. by inference there is slack in the system so reducing GPs T&Cs is seen as fair by the public. No member of the public sees GPs as poorly paid - GPs are viewed as either well paid but deserving of it or simply overpaid (Taxpayers alliance).

    In short if you want the NHS then you will have to take the medicine that the government is dishing out and there is plenty more to come.

    I once had faith in the NHS but not any more. The NHS is now corrupt, politically driven and abused by staff and patients. The future should be in a new model of care. I have no interest in propping up the NHS. However, there is no group to represent me but I do get the feeling that a lot of 'fed up' GPs do feel the same way.

    There is no 'choice' in regards to the NHS contract and there never will be as I've argued all the representative bodies are tethered to it. Well. I guess that's democracy in the NHS for you.

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  • A new model should be a private system with GPs in control i.e. like dental colleagues.

    If individual GPs want to provide free care for the poor they can within that model.

    If the profession continues on current trajectory we heading towards large corporations taking over.

    If alternative models are not discussed it will be the end.

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  • 11:48
    You are totally right. There are many of us who agree that the NHS system is not acceptable in its current form. Our representative bodies are not even asking us what we want, let alone discussing an alternative from the NHS!

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  • Interesting bearing in mind the recent poll / article in Pulse that suggested being a GP was one of the happiest jobs to have!

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  • A system of copayments and private practice is the only way forward to preserve the partnership model. The BMA needs to wake up and negotiate an exit for all GPs

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  • Una Coales

    @4:26 pm I agree. I have suggested to the BMA sessional GP subcommittee that we invite Dr Fiona Payne, former NHS GP partner and now private GP and IDF GP chair to give a talk at the annual conference November 14 on how to be a private GP. We have to give options on how to survive, think outside of the box, to pay bills as MPIG wipes out more practice income.

    Unless government allows GP surgeries to thrive by offering co payments, state patients will have no where to go but to privatised HMOs and self pay or take out PMI. I can visualise hospital beds left empty for private patients and the poor and elderly unable to afford PMI.

    If all GP surgeries hand over their surgeries to HMOs, then there is no state GP.

    I foresee government tightening the thumbscrews by making GPs pay to be appraised £500-£700, appraised and revalidated by nonmedical officers, changing the rules and taxing of lump sum pension pay outs when you try to cash out. By allowing you to cash out the entire sum in your pension, government can then introduce a tax of 50-55% on your entire lump sum cashout!

    Every way you look at this, they will not make working for the NHS viable. BMA must show members how to survive financially.

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