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CAMHS won't see you now

Tempting fresh meat onto the general practice BBQ

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As a GP trainer, I’ve been wondering recently how we can persuade more junior doctors to enter general practice. Let’s leave aside for a moment whether such an action could be deemed ethical, and think about how the hell we actually do it. I suggested a couple of months ago that a major upgrade in pay and conditions à la 2004 was our best bet, so like everyone else I found myself awaiting the unveiling of Jeremy Hunt’s package with bated breath, and like everyone else, my reaction has been… meh.

Come and be a GP - a job that’s so likely to make you mentally unwell that we’ve had to hardwire treatment into your contract!

I’ve been reading up on the GP Forward View and I’m still none the wiser. It seems like there’s some kind of extra money being promised, but it’s hard to pin down exactly when it starts benefitting individual GPs. When Pulse asked Simon Stevens directly whether we could expect a pay rise he was cagier than London Zoo. You hear billions being bandied about but, as the redoubtable cynics at Resilient GP have pointed out, the promised investment won’t even get us back to historic levels of funding. It’s a bit like when the surgeons asked John Wayne Bobbitt if he wanted them to sew his willy back on; obviously he’s going to say yes, but no-one should pretend he’ll end up better off than he was to start with.

I realise I’m at risk of sounding like Morrie the wig salesman from Goodfellas here. It’s not all about the money, after all. There is even some good news. I’m pleased about the proposed ban on me being asked to write referrals on behalf of secondary care. Any acknowledgement that GP time is not a bottomless resource to be tapped at will by our hospital colleagues is fine by me, though it remains to be seen whether it actually works in practice. And the long overdue investment in mental health support for GPs is to be welcomed, though it’s hardly a great selling point for the profession: ‘Hey kids! Come and be a GP - a job that’s so likely to make you mentally unwell that we’ve had to hardwire treatment into your contract!’

So I’m not sure if there’s anything here to entice fresh meat into general practice. Our only hope is that the DH’s current crusade against junior doctors will make the hospital frying pan so awful that a jump into the primary care fire starts to look appealing. See you in five years folks!

Dr Pete Deveson is a GP in Surrey. You can follow him on Twitter @PeteDeveson

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Readers' comments (3)

  • Why jump from fire to fire? Youngsters are not desperate to become doctors/GPs/Consultants anymore. A medical degree opens many doors these days. Gone are the brainwashed-by-the-state doctors... vacation....look into my eyes....duty of care.....look into my eyes, not around the eyes...self-sacrifice for no pay...deep into my eyes who stupid idiot huh and 3-2-1 back in the consulting room.

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  • The reluctance to make any attempt to limit access means that most consultations are trivial and could be adequately managed by someone far cheaper than a GP. Does it take a GP to rubber-stamp a med3, hand out some SSRIs to unhappy people or reassure someone with a cold? "Had a chat with patient" is a popular Read code - which tells us lots about consultations. Much of chronic disease management may actually be done better by someone who does nothing else.
    The future of GP is a small number of clinical leads, probably but not necessarily GPs, directing a team of nocters, phocters and PAs.
    Hopefully, some patients will realise better advice will be available from experienced GPs and private practice will be a plausible way to earn a living again, out from under the big boots of the Nash.

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  • I think we should actively discourage any Juniors from entering General Practice: the best kind of direct action we could take. This is a valid twist on the "Duty of Candour" we have all supposedly signed up to..! I am at the stage where I would like there to be no General Practice as it would be the best and comforting proof of whether we are needed: we are starting to question our own value, and that is a very worrying sign. Like Copperfield, I don't mind any more looking for another career (in my case as long as I can accept that my last one was a huge waste of time). There would be a nice bit of real estate in London to sell off (RCGP Towers) and all those people who try hard not to come to work by watching those who do, could also get down to the Job Centre! (eg Responsible Officers, Deanery pukes etc)

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