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What will the next five years hold for GPs?

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The NHS is a socialised health system. It relies on individuals and institutions earning money to pay taxes into a central pot, from which a proportion is used as the health budget. There can be no denying that it operates on socialist principles. It is feted as something that makes the UK great, resonating with the statement of Mahatma Ghandi that ‘a nation’s greatness is measured by how it treats its weakest members’. 

We now have a government that is committed to principles of capitalism, ideologically opposed to socialist values, and as a party has previously privatised the railways, energy companies, telecommunications, the mail system and the prisons in part. Allowing market economics to prevail seems akin to making the pervading principle: ‘Every man/woman/child for themselves’. 

This is made even clearer by the pre-election pledge to cut the welfare bill of the country by £12 billion. We all need to be taking home more money so we have to rely less on one another.

The question on the lips of colleagues working in the NHS, especially in England, in the last few days has been: ‘What will happen to the NHS in the next five years?’

My crystal ball unfortunately holds few answers. Maybe uncertainty will undermine any attempts to resolve the various crises - if that is not too strong a word - affecting general practice in particular; issues of recruitment, retention, workload and morale being perhaps the most pertinent.

I would hazard a guess, crystal ball discarded, at the following:

- Any attempt to repeal or amend the Health and Social Care Act in parliament will fail as the whips of a majority government will ensure it remains.

- The pressure on health services will increase as continued austerity measures and promised cuts in welfare push older and frailer patients to seek help from the point of care of least resistance.

- The portrayal of general practice in the media, fed by the government, will continue to be negative as the current government will need someone to blame the ‘failure’ of the NHS on, thereby legitimising its privatisation.

The next five years could determine whether socialised health care can be compatible with the ethos of consumerism, encouraged in our patients, that is derived from the application of market economic principles.

Good luck, everyone. I think we’re going to need it.

Dr Samir Dawlatly is a former secretary of the RCGP’s adolescent health group and a GP in Birmingham.

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Readers' comments (11)

  • You have said everything I think !

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  • Vinci Ho

    As I commented in Nigel's editorial , Cameron and his subordinates would be foolish if they thought this general election result was a proud victory . They should be humbled by the fact the country is now clearly divided with polarities . Recipes of danger are everywhere for them if they completely ignore people's voices.
    For us , the battle goes on no matter what , only if we can stand even closer together , up against the tyranny....... I believe the soul searching is not just for the losers.

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  • Market the profession as Consultants, put us on billboards in white coats and that brain trickery might do the trick to gain some homeopathic concentration of respect. Then get in some celebrities like Angelina Jolie, David Beckham or Justin Beiber to fight our cause. Simple.

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  • the government is simply going to deliver what it promised the electorate i.e. the ability to see a GP 12 hours a day 7 days a week.

    in addition there will be more competition and practices will have to federate or join together somehow to survive whilst cutting costs and taking on more work.

    the majority will and slowly there will be a move to salaried / employed service and likely 24 hr service.

    it's achievable in 5 years and will be supported by most GPs and GP leadership.

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  • 1.51pm,impossible without a dilution of service.I for one do not agree with this plan and would leave before cooperating.

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  • we're all doomed i tell ya! doomed!!

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  • 1 year 5 months 17 days
    Such a shame the NHS is a great system being abused by some patients and the politicians or rather the civil servants
    Jeremy Hunt has blocked my emails So much for free speech
    Now going anonymous as am already branded a trouble maker!!

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  • "It relies on individuals and institutions earning money to pay taxes into a central pot, from which a proportion is used to as the health budget"

    I think doctors need to take a serious look at modern thinking about how fiat economies run. The Government does not need to EARN money (eg via taxes) in order to issue spending power to the economy it runs. The Government is the SOLE SOURCE of legal lender in its dominion.

    Get this straight: the process of clearing liquidity from the economy (ie taxes) HAS NOTHING TO DO with Governments ability to issue spreadsheet credit to persons and institutions (yours and your local hospital's income) who have an account with it.

    Read up a bit on Modern Monetary Theory please.

    Anyway, whether or not a spending programme is embarked upon by Government is 100% to do with the political willingness and expediency of said decision - and nothing to do with notions of "tax revenue". Tax is just a sump which clears money from the economy to stop prices rising.

    If a Governemnt says it can't pay GPs....it is because they DON'T WANT to pay GPs enough. Nothing to do with budget deficits or surpluses.

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  • Alan Shortt

    "If a Government says it can't pay GPs....it is because they DON'T WANT to pay GPs enough. Nothing to do with budget deficits or surpluses."

    I agree with that but would add NHS specialists, nurses, ahps, teachers, social workers, dinner ladies, traffic wardens, da police, armed forces, civil servants, bus-drivers, school-leavers etc

    I'm not sure Monetary Theory and Economics illuminates or proves one thing or another but I think I agree - in particular Austerity is a Lie - but opinions are like aerosols - everyone's got one - except perhaps for the increasing tranche of neo-poor destined to become Orwell's even smellier proletarians on the road to wigan pier

    I'm not sure Monetary Theory and Economics illuminates or proves one thing or another but I think I agree - in particular Austerity is a Lie - but opinions are like aerosols - everyone's got one - except perhaps for the increasing tranche of neo-poor destined to become Orwell's even smellier proletarians on the road to wigan pier

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  • Alan Shortt

    apologies no opportunity to edit on this site

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