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At the heart of general practice since 1960

GPs need to show our hand

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You remember the game? It’s a test of nerve, you mustn’t back down: loser blinks first.

It’s simple: the NHS is in crisis, and no more so than in general practice. Day in, day out the pressure is enormous. I love the job that I should be doing. I think I am reasonably good at the job I should be doing, I act safely in the job that I should be doing. But this is not the job that I should be doing.

I think it’s time we showed our hand, to let the public know what their options are

The paperwork is drowning me, the limitless demand, the shift of responsibility from everyone, everywhere to general practice. It is draining.

And is it safe? Hand on heart, I no longer feel that I can practice safe medicine on a daily basis. So what’s the answer?

We’re trying not to blink, but our eyes are watering now.

At the moment it seems the solution is that we magic GPs out of nowhere, organise and reorganise, and just hope it all sorts itself out. Or we throw a smidgeon of money at some bits of it. Not money where it needs to go, but money that you have to fight for, that goes to where the powers that be think it should go. Or is there another answer?

Eyes straining: we… must… not… blink?

But this this game has gone on too long. The NHS is being starved, this is becoming all too clear, even senior Tory MPs like Dr Sarah Wollaston are highlighting the misleading investment figures.

One solution: general practice needs money in its core contract. Stabilise general practice you stabilise the NHS. So the answer is you increase taxes to pay for it. Simple.

Except no politician will suggest that, and few voters will agree to it. So what next?

It’s the final part of the match; we’re never going to win. It is clear that in this competition, the other side has bilateral Bell’s Palsy.

We blink

It is high time someone raised and discussed our options, however unpopular they may be. If the answer is not taxes, what else? What are the alternatives? The Government refuses to blink, so perhaps we need to force their hand and work up safe, sustainable, alternative models for the funding of general practice. I was therefore encouraged to see the announcement this week that in some areas of the country, a ‘Plan B’ to take GP practices outside the NHS is being discussed.

Please don’t misunderstand me (I’m looking at you ‘anonymous healthcare professional’ commenter), I work in an inner city practice and see deprivation day in and day out. I see the consequences of welfare cuts and part-privatisation. I don’t want a two-tier system of health care, I don’t want the most needy getting the worst care.

But what I do want is stability, and safe, quality care for doctors and patients alike. I think it’s time we showed our hand, to let the public know what their options are. To demand what we really need, open and honest debate on the future of general practice.

No one else is blinking on this issue, and until they do it seems covert privatisation and collapse of NHS general practice is inevitable. Sold to the highest bidder solely for profits not patients.

Let’s not allow that to happen. I look forward to Plan B.

Dr Susie Bayley is a GP in Derby and chair of GP Survival. You can follow her on Twitter @susiebayley

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Readers' comments (13)

  • Superbly articulates my thoughts. Well said Susie.

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  • Very succinctly put and I wholeheartedly agree!

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  • What are you talking about? According to the RCGP, "there has never been a better time to be a GP".

    And Chaand Nagpaul at the GPC seems to be very keen that GPs never take any action about anything so there can't be anything much wrong.

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  • There is ,of course, plenty of money out there . It is not well distributed - Getting back 11% of NHS funding would help. Also a tax on financial transactions -say 0.5% would cover it.

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  • Money could come from secondary care...after all they aren't doing the work - so give it to those that are!

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  • I though the work was excessive 5 years ago when I left.

    My ex partners tell me the workload and demands have easily doubled since then.

    The workload and demands on an average GP cannot be safe.

    I agree there is ample funds out there but they needs tough choices to ensure they get to right place

    Quangos such as CQC, ineffective HEE or money for frontline?

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  • Is it the whole hand which should be shown or just a few fingers?

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  • Block us being sued, and we will save 20% of the NHS budget over-medicalising and another 10% in payouts not correlated to need or harm. That could be helpful to improve NHS and social care budgets.
    I might even want to remain a GP...
    Risk is a huge issue. I feel forced to over-investigate, over-prescribe and generally over-medicalise to cover my arse.
    How many times today did you add a useless comment to a record to cover your backside?
    the NHS 111 records are a computer generated pile of BS, again to cover risk. Why don't people want to work where the fun is? because A&E and GP are the most RISKY! The legal stuff is the real cancer destroying the NHS.
    We need to first aim the "proton beam" at the lawyers.

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  • We do need to be taking the initiative on alternative models of funding. A UK wide 'plan B' should be considered. Through-out my career there has been a tension between what I've been asked to do by the people funding the service and what is actually safe and achievable clinically. It has always been the case that we are asked to do more than is safe or reasonable. The difference has generally been covered by 'good will' and going 'the extra mile'. Those demanding we do ever more for less and less are safe in the knowledge that if anything goes wrong it's he clinician that gets the blame...not the funder. We have always had a responsibility to speak up when the system isn't safe. That is true now more than ever. The system is simply not safe...we need to be honest and insist it's put right. If we don't and we screw up..we will be blamed, not those several steps removed at the treasury. The NHS is broken and we at going to the ones held responsible for the damage. The sooner it's fixed the better. If you work in a broken system, you are supporting it. If it can't be fixed we should leave.

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  • Well said.

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