Why I left Britain (and I'm not coming back)
Golden hellos can’t beat golden beaches, writes Dr Gaurav Tewary
I left my job in Coventry less than a year ago for Australia because I was getting fed up with the NHS - the constant restructuring, the erosion of its basic principles and the constant media negativity about GPs.
Working in Australia has been amazing, mainly because of the lifestyle. I currently live in New South Wales. The city has great weather, amazing beaches, and I have an excellent work-life balance.
GPs are also much better rewarded in Australia than they are in the UK - for example, unlike in the NHS, money paid into superannuation can be used to invest in property.
There are drawbacks, of course. Australia is far from everywhere and even the distances within Australia are huge. Sydney to Perth is five hours by air. Roads can be rough and amenities scarce along the way so the choice of city is crucial. Family back in UK seem very far away and the reversed seasons can also make you feel alienated. Christmas on the beach doesn’t seem quite the same.
And while there is great autonomy in practising medicine here, there is greater uncertainty too. You could have a surgery that is doing very well but without warning a new medical centre might open next door offering 8am-to-8pm appointments seven days a week, as well as cheaper services. Suddenly your list could halve in number.
Wherever you go in the world you will never get away from politics and Australia is no exception. Like the UK, this country has excellent outcomes for patients, its health budget is only a small percentage of its GDP, and its primary care system delivers a lot of bang for the money spent on it. Yet - again like the UK - politicians here are hellbent on trying to ‘improve it’.
There is talk of introducing ‘blended payments’ - a mix of fee-for-service and capitation-based payments for GPs. There is also talk of a US-style Health Maintenance Organisations payment system and Australia has employed the University of Plymouth to help it devise a system of revalidation. But the response from the public and the profession here is much more robust than in the UK and several proposals, including co-payments, have already been rejected.
I don’t regret my move one bit. People ask if the new returners’ scheme would tempt me back. There is no response other than to laugh. I spent the equivalent of around £30,000 to get away from it all. Why would I return for half that sum, and more of the same problems?
Dr Gaurav Tewary is a GP in Wollongong, New South Wales, Australia