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GPs buried under trusts' workload dump

GPs operating in an 'unforgiving climate of blame', says GPC leader in defiant speech

GPs are operating in an 'unforgiving climate of blame' through having to deal with pressure from litigation and the CQC while tackling 'unsafe' workloads, GPC chair Dr Chaand Nagpaul will say in a speech to the BMA's annual conference.

Addressing doctors from across specialties at the BMA's Annual Representatives Meeting in Belfast, Dr Chaand Nagpaul will say that 'pressures on general practice have sunk to new depths' since last year's meeting.

He will promise that GPs will fight every day to resurrect their 'proud profession' and highlight the fact that at the LMCs Conference in May, GP leaders gave the Government three months to accept the recommendations in the GPC's Urgent Prescription for General Practice or they would canvass the profession on its willingness to submit undated resignations.

Dr Nagpaul will lament the 'explicit wholesale transfer of care out of hospital' which 'continues unabated'.

He will raise troubling statistics, including:

He will say that all of this combined 'has led to a toxic mix from which existing GPs can’t wait to escape, and which many young doctors will not join'.

Dr Nagpaul will add: 'Far from the being thanked for working against all odds, there’s an unforgiving climate of blame. Litigation against GPs has rocketed, no doubt contributed to by us not being able to work safely. CQC adds further insult by crudely judging practices rather than recognising our impossible context.

'How callous to name and shame practices for not having the capacity to tick boxes when those struggling the most are rightly spending their time attending to patients rather than producing reams of policies to satisfy the clipboards of inspectors.'

And while general practice needs more funding, Dr Nagpaul does not want this to come out of the hospitals' budget.

He will say: 'The elephant in the room is of course money. As a supposed rich nation it’s shameful we spend less of GDP on health than most of the developed world, where we have a fraction of the hospital beds of France and Germany and lag behind most other OECD countries in our doctor and nurse numbers.

'General practice desperately needs more resources, but not by robbing Peter to pay Paul, but from a larger NHS pot that provides the level of care that befits a civilised state.

'This is everyone's fight, from doctors to patients and the public as taxpayers, to challenge politicians who are irresponsibly trying to squeeze a quart into a pint, while savagely slashing NHS funds under self-proclaimed austerity.'

Readers' comments (19)

  • 'given that there is no money or funding - what is the solution ?'

    Drop the communist presumpton that all have to be 'equal'.
    Allow top up payments and co-payments like in the rest of Europe.

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  • Yet again the tired old Geldof solution to all woes: "Gives us your f..ng money!". How much do you want Chand?Have you costed it? Any idea how many billions we have already had? The NHS is awash with money, but most is soaked up on staff costs and the rest is squandered in a highly inefficient manner.I speak with battle-scarred experience as a GP Lead on Finance at a CCG.
    The problem is the concept of an amorphous, unresponsive and unaccountable nationalised organisation, not how it is funded.Throwing money at it has not helped in the past.
    If the end is providing a reasonable standard of public health funded by central taxation, we should go right back to the drawing board and review how we construct the means to achieving that end.Bankrolling the status quo is not the answer.

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  • Wake up, take a step back and let's be objective ……there will never be a glass big enough for the water pouring in and overflowing. This is the ‘me, me, me, now, now, now’ generation not the 'sorry to trouble you doc, would you mind' early days of the NHS. Either we cut demand dramatically and stop medicalisng non-medical conditions, or fund it adequately with massive (unaffordable) tax increases or a private insurance scheme partly based on peoples choices, and responsibility and accountability – of which there is zero currently. There needs to be a blunt and honest debate that is being hindered by the NHS holy cow.

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  • Toxic words but - no toxic or otherwise any action from this man.

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  • I am very sorry to read the posts of my fellow colleagues - your concerns are palpable.

    Anyone who has spent time in GP, knows how hard it has become now. As GPs, we've given from the very beginning and continued to give in very difficult circumstances.

    This situation cannot be sustained. The country, its people and the dedicated professionals within the NHS deserve better. That will only happen when we start to think and change.

    I have drawn up a list of things to do that may help. Please feel free to add to this:-

    1) Take the NHS out of the current method of administration. Consider a cross party organisation to safeguard it.

    2) Appoint a health secretary who, by definition of his/her role, must have significant healthcare experience.

    3) Ensure people, especially in the roles above, have no vested interests.

    4) Educate patients regarding the cost of healthcare and how it is funded.

    5) Consider ways of tackling the inappropriate use of NHS resources.

    6) Value General Practice. We, as GPs, are dedicated professionals, whose breadth of knowledge spans many areas.

    7) Take a fresh look at funding and the allocation of money.

    We need to have these discussions. I have always thought British General Practice is something "extra special". I would like to think that I am not alone on this.

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  • The situation is unsustainable as we as GPs just simply work harder.

    Consultants do not see more than their number in a clinic and do not do extra clinics unless paid.

    We should reduce our capacity in line with reduced funding ie offer less appointments, take time out of clinics to do admin, CQC appraisal etc

    And ask patients to go to AE instead. We have been keeping working harder to keep NHS costs down but hospitals and trust generate more work and income and hence keep getting more funding.

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  • So many Consultants are struggling too. [A+E and other consultants in N Ireland do those frightening 80 hour weekends with 3/4 hours sleep] Chopping their legs off is not the answer.Co- payments maybe.

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  • THERE IS NOT A SENSE OF URGENCY FROM NHS ENGLAND. IT HAS TAKEN THEM 2 YEARS TO COME UP WITH A SOLUTION FOR INDEMNITY COSYS AND WE ARE STILL WAITING. THEY WORK AT TITANIC PACE . MOST OF US ARE STILL WAITING FOR THE PROMISED INVESTMENT. IT SEEMS TO BE LIKE THE ELUSIVE PIMPERNEL.

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  • Anonymous | Salaried GP22 Jun 2016 7:43pm:
    "4) Educate patients regarding the cost of healthcare and how it is funded."

    One way to "educate" is to charge a proportionate co-pay.

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