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At the heart of general practice since 1960

There’s a hole in your manifesto, dear David, a hole

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As I read the Conservative manifesto yesterday, I was reminded me of an old playground song about having a ‘hole in my bucket’.

You know the one, ‘There’s a hole in my bucket, dear Liza, dear Liza. There’s a hole in my bucket, dear Liza, a hole.’ Because a glaring aperture in the base of the new shiny pail being presented by the Tories was the promise of 5,000 new GPs.

In our recent Q&A with the Prime Minister, David Cameron said that ‘making sure we have the right number of well-trained, motivated staff is key to the future of care in this country’.

But despite this, he seems to have conveniently left a promise to boost GPs out of his blueprint on how he will run the country if he forms a Government from May.

He remembered to put in the (badly worded) promise that everyone will have access to ‘your GP’ seven-days a week.

The pledge that everyone will have a specific, named GP.

That all patients aged 75 and over will have the right to a same-day appointment if they need one (although who will decide ‘if they need one’ is not explained).

But on the matter of staffing these ambitious pledges? Some woolly words on continuing ‘to ensure that we have enough doctors … to meet patients’ needs’.

Continuing? That is a joke. We may have 1.7% more full-time equivalent GPs since 2013, but this is way below what is needed if you listen to the recruitment problems that practices are having at the moment.

Despite promises to boost the number of GPs in training, we have seen the worst recruitment round in seven years. And figures revealed by Pulse show this year could reach a new low.

BMA survey figures released today show the extent of the leaky bucket of GPs, with a looming retirement boom and one in five trainees saying they will simply get through training and then disappear on the nearest plane to practise abroad.

I could go on.

The fact is the Conservatives - and Labour, which promises 8,000 more GPs - know they will struggle to deliver an increase in GPs unless something fundamental is done to reduce the pressures on the service so that doctors in training see the profession as an attractive place to work.

Why would you become a GP if you see partners working 10-hour days and buried under piles of paperwork rather than treating patients?

Funding is key here, but let’s be honest the biggest problem is that morale in the profession has reached a nadir that it will be very hard to keep the existing numbers of GPs, let alone grow them.

Rebuilding faith in the profession means rethinking entirely the high-handed NHS approach to GPs, stopping the negative briefing against the profession and defining carefully what general practice is there to provide, and most crucially, what it isn’t.

But then I suspect, Mr Cameron, you know that already and that is why no numbers appear in your manifesto.

Then fix it, dear David, dear David, dear David. Oh fix it, dear David, dear David, stop talking and just fix it.

Nigel Praities is editor of Pulse

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Readers' comments (9)

  • Not sure why they didn't include a promise of 5,000 more GPs in their manifesto anyway seeing as there's no law that says they have to deliver on their promises. Wasn't "no top down reorganisation of the NHS" part of their last manifesto?

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  • It's not just a funding/workload crisis, although that underlies many of the problems. The BMA survey showed that other factors are driving GPs to retire early or move abroad. These include lack of time with patients (10 min appointments), the shifting of work from secondary to primary care, constant organisational changes and over-regulation. There are also attacks on pay and pensions and ever-increasing medical indemnity premiums. You will not solve this crisis JUST by throwing money at it, important though that is. You need to address all these other issues as well, rather than the government constantly asking itself how much it can get away with. The answer to that question is undoubtedly "far less than you have already done."

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  • Vinci Ho

    You see . There is no conviction , no commitment to fix it as far as Cameron is concerned . When he deliberately quoted the infamous saying of the current RCGP chair that there was no better than to become a GP, he was looking the 'easy' way out. See the true face of the man who has absolutely zero sincerity to fix this crisis in general practice( he alluded there was no crisis anyway).
    History will judge these people.....

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  • Vinci Ho

    ...no better time...
    Apology

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  • Where can I find a 10 hour a day GP partnership please?

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  • I know someone who was at a party with him in London shortly after he was elected - unbeknown to him that there was a GP in earshot, he allegedly said his first priority was to 'sort GPs out as they did too little work for too much pay after the 2004 contract, as everyone knows' This has stuck with me ever since and I am therefore not remotely surprised that he and his party and the likeminded press - even the Guardian until recently - have spent the last 5 years running us down, increasing our workload, and decreasing our pay whilst increasing our pension payments and the time we can retire - this is just the icing on the cake!

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  • Whether a reorganisation is "top-down" or not is open to interpretation. Promising "5000 more GPs" mean what it says - and he knows that he would be setting himself up to fail.

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  • Dear 5.46 pm , when the 2004 contract came in , there were no partnerships available, unless you had a family member or friend that owed a practice, there were badly abused salarieds ( of which I was one for 10 yrs in three separate jobs ) so when I could not either get a partnership or get a decent salaried job where were you ?No wonder he wanted to sort GPs out you were all being selfish and abusive to other Doctors and this was not fair, so why complain now ?At least there are posts to be had now and you don't have to be friends or related to anyone to get them , sadly we are worse off , but I think we brought this situation on ourselves where fairness went out the window when push came to shove !

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  • Echoing 0847's comment....
    I was working as salaried in 2004. The partners at my place were cock-a-hoop, dancing on the ceiling, popping champagne corks, fist-pumping...when they learned that their 24 hour responsibility for their patients (the sine qua non of UK General Practice, no?) was being struck out in law, never to return. Very high ranking FRCGPs were very open about their interest in making as much money as possible, and seeing as few patients as possible, and never doing home visits, and dumping on the salaried lackeys.
    I am writing this 16000km away from the UK NHS. I quite like what I have seen of David Cameron - in 2010, it is of no surprise to me that he wanted, on behalf of the public (and the salaried lackeys) that he wanted to sort out GP (partners).
    It's been five years of pay back, not in absolute terms, undeserved.

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