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The waiting game

Dr Chaand Nagpaul: ‘These statistics are tragic’

GPC chair Dr Chaand Nagpaul on the BMA survey showing GPs planning to leave the profession

It’s tragic that one in five trainees is intending to work overseas. It costs half a million pounds to train a GP and that’s an utter waste to the taxpayer if they go abroad afterwards.

But it’s a reflection of the workload. I don’t know from this survey where the doctors plan to go to, but we know already that countries such as Australia, New Zealand and Canada are attracting GPs from the UK.

It’s no good just recruiting more GPs if it’s going to be more than offset by those leaving the profession. It’s crucial to retain the workforce. If you don’t, the workload will become increasingly heavy and you won’t be able to attract more GPs.

But only half of GPs would recommend general practice as a career. I fought to be a GP and feel very privileged to be in the profession. It is such a shame that the pressures of the job have resulted in such low numbers of recommendations.

Unless you address what’s putting off GPs there will be a serious risk that we won’t have the infrastructure to meet patient need in years to come. A big problem is that unresourced work is continually shifting into the community. Early discharge schemes mean that patients book more appointments with their GPs as a result.

Patients need more follow-up appointments and on top of that there are more sutures that have to be removed by practice nurses. I’ve written to CCGs and told them that any commissioning change like this should be examined for workload implications.

But there is a transfer of this work towards GPs without the extra support. We need to send out a message that general practice must not be a back-stop for all these policies. Work is being transferred to general practice, expecting it to be a sponge without a saturation point.

At the moment there’s a total denial of the problems. The most important thing is that policy makers open their eyes – because the challenges experienced by general practice are staring them in the face.

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Readers' comments (8)

  • typical GPC waffle....blah, blah , blah
    The point in all this is that the GPC is supposed to represent Doctors many of whom would like to see a debate about removing our services from the NHS in the face of intolerable conditions.

    The GPC should be leading this debate. The survey is useful but not if the GPC is waiting and hoping that the DOH or NHSE will suddenly care what happens to GPs.

    If the survey is to be nothing more than a GPC paper exercise then it biggest use is a "date-stamp". When primary care collapses the date of the survey can be used to hold the Government to account as there was a clear warning in the statistics... this will all be too late for GPs (and their patients) as once we are gone it is highly unlikely any of us will return to NHS serfdom.

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  • Sadly 10:07 the GPC requires rank and file support to take up any action on your behalf - I have often asked why they don't to be told that when push comes to shove the only people carrying the flag are the GPC/LMC committee's and their dogs

    Trying to get GPs to stand up and fight is like herding cats - they shout / moan but do not come together in support

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  • The NHS costs the Government roughly the same amount as it spends on pensions. The UK is financially bust. No government is going to spend any more on health care until economic conditions improve. All clinicians, including GPs, are now considered fair game and to be pilloried. Somehow we are expected to cope with all the extra demands put on us. This will be ongoing.

    There is no other solution than to resign from the NHS and dictate our own terms to whoever wishes to pay us, whether that is patients directly, private insurance, or whatever is left of the NHS

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  • What's more tragic is the GPC is doing f-all about worsening conditions. and as for PM, we DO want to take action, but are prevented from doing so by GPC/GMC/NHSE et al. look at what happened on to our day of action

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  • Vinci Ho

    A Chinese saying : Three feet of ice and snow was not down to one day cold.
    While I have already given up on the college , still am willing to give a benefit of doubt to you and GPC. The way to negotiate with the next government for our contract has to be changed.How? That is why you have to be 'the wiser'. While you can try to reassure yourself history does go in circles, this is a critical time in the history of general practice in this country when any critical decision might have a far reaching consequence for the generations coming.
    'Whoever in discussion adduces authorityuses not intellect but rather memory.' Leonardo da Vinci

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  • Payment by activity. the only way to save general practice. And that is every activity (blood results, face to face, phone, skype, hospital dump etc). block contract is a thing of the past and must come to an end at the next negotiation. End of....

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  • Practice Manager, 12.46,
    How right you are. GPs will moan behind doors but do not have the courage to act. How sad, nurses and midwives are far more courageous including their leaders.
    The disconnect our public and politicians have with health services is unbelievable.

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  • Dubia, Qatar are after them too so I hear.

    Then there are some nice clinics, well paid in The Caribbean treating expats and tourists.

    Also, packages are good for The Falklands, The Artic and other Islands in the middle of nowhere...anywhere but in England...

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