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Independents' Day

Life as a GP in Nova Scotia is so much better

Dr Simon Bonnington, formerly a GP in Somerset and an LMC vice-chair, on why working as a GP in Canada beats the UK hands down


Dr Simon Bonnington - online

Profile: Dr Simon Bonnington

Age: 47

Role: Family physician

Location: Annapolis, Nova Scotia

Career: A former GP in Somerset and vice-chair of Somerset LMC; emigrated to Canada in 2010




The deep-throated gunning of an engine and a flash of amber lights penetrate my slumber. My subconscious recalls the 4am clatter of the highways snowplough.


By the time I leave the house, the night’s four-inch snowfall has been cleared from our drive by Eric, our 77-year-old neighbour, with his plough. Like so many of my youthful elderly patients, he stretches his pension with small jobs. The warm midwinter sun greets my face. We’re on the same latitude as Turin and much of the snow will be gone by late afternoon.

My drive to work takes six minutes as I cross the causeway, pass the hydro- electric plant, halt at our only traffic-lights, then stop for the school bus.


The brick and concrete health centre offers a stark contrast to the elegant 19th-century houses in the town. I ask the nurses about our four inpatients. The patient with diverticulitis is still pyrexial, her white cell count not settled, but she was comfortable through the night.

I walk along to our practice offices and start the computers. Letters wait on my desk for signatures. Electronic lab and X-ray reports lurk in the Nightingale inbox – our equivalent to EMIS.


We meet for our daily multidisciplinary morning rounds. I review the patient with diverticulitis. Phoning the hospital, I speak directly to the consultant surgeon on call, then to the radiologist to arrange the CT. A nurse organises the ambulance. We’ll have an answer by lunchtime.


My morning clinic of 15-minute appointments runs until 12pm, with time set aside to review our two registrars. My $300,000 retainer contract (approximately £180,000) covers 40 hours for 46 weeks, plus 19 weekend days a year, including 1:6 emergency department coverage, and overnight inpatient responsibility. Our practice is more chambers than partnership, with rent, staff and overheads provided by the health authority at cost. They employ our nurse practitioner and practice nurse, at no charge to us. No list size to worry about, no visits, no LES, NES, DES, no commissioning and no federations. Incorporation offsets my tax liability to 30%.

I have better hours, more money and less stress than in the NHS I left in 2010. What’s not to like?


Our unionised reception staff must have an hour’s break for lunch, so the shutters and phones go down. It’s just $4 (£2.40) for a freshly cooked lunch from the canteen.


Clinic until 5pm. A patient with COPD comes in, breathing badly. He hadn’t liked to call an ambulance because of the cost and couldn’t afford the prescription for the inhalers. I take him straight over to our small emergency department where point-of-care blood count, electrolytes and chest X-ray are available. We admit him for nebulisers, steroids and antibiotics. This is his second exacerbation, so I reassure him he’ll get coverage from the Government.

A collective collegiate environment encourages doctors to seek advice from each other several times a day. I’m the go-to for chronic pain.


Home in time for supper with my wife and children. The kids head off to their skating lessons at our local rink, while I head to the high school gym for soccer.


The kids are in bed. My wife and I relax with a glass of home-brewed wine to enjoy the latest episode of Murdoch Mysteries, a popular TV detective drama in Canada.

Readers' comments (11)

  • hmmmmm, sounds a bit to perfect me thinks...............46 weeks at 40 hours + 9.5 weekends +overnight responsibility : I'm making more doing less in the UK. sounds like you had a crappy job in the nhs before you left!!! good luck and i hope it works out!!!

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  • Sounds good. I made the move to Australia, and For me it's just as good if not better - you don't have the extreme cold, but you do have very hot summers. Over here, fee-for-service means the harder you work, the more you're rewarded. And 15 minute appointments mean you can deal with issues in greater depth - more patient and doctor satisfaction.

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  • Anonymous 10.51am - more for less you get?! Are you a GP? What am I doing wrong?

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  • I'm booking my ticket now!

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  • After 15 years in GP land I would consider myself relatively deskilled in acute hospital medicine.As a refresher,did you do a short stint in hospital medicine before taking up this job?

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  • I wonder what colour the grass is over there?

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  • Nice to see that Canada is benefiting from your UK paid education

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  • "Nice to see that Canada is benefiting from your UK paid education"
    Not a sensible remark considering the number of health professionals that have been trained abroad at no cost to the British taxpayer and that Dr Bonnington had already put 20+ years to the service of the British population. Only good can come from professionals from all walks of life experiencing other cultures and ways of doing things surely?

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  • Hi Simon good to hear from you and best, jealous wishes.

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  • Ian,
    I thought students pay for education in the UK. I paid very little where I educated but I had to work for the government to compensate for the benefits of free education.
    As a separate issue, I think it's the government of the countries who need to look at their policies so that they keep doctors or other professionals around. What I see now, I can see the present government is not much interested in retaining the workforce. The reason? I don't know!
    Anyway, if we come down from our chair of politics, we are all humans and we move where we are better appreciated and more respected. After all, I should repeat Darwin's sentence that was one of my friend's pet expression: the most intelligent of species are not the survivors, but those who adapt with change (with a bit of modification).

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