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Independents' Day

GPs have a duty to support the junior doctors - it will be our turn next

From Dr Michael Crow, locum GP in South West London and Surrey and ex-medical director of OOH Services (Thamesdoc, Harmoni and Care UK)

The medical profession should unite, which means that consultants, GPs and junior doctors should support each other.

While I would not have supported strike action in the past, the goodwill upon which the NHS has been run has probably run out

I am a GP who qualified in 1981. This puts me in the same vintage as Dr Nick Summerton. While I would tend to agree with his sentiments that doctors should not strike, I think that the current situation with junior doctors has left them very little choice.

Yes, back in the 80s junior doctors worked ridiculous hours, but it was not safe to do so then, and it is even more unsafe now. When I was a houseman/SHO I was part of a firm with a hierarchy of consultant/registrar/SHO and possibly a PRHO. We were a team and knew all of our patients. I lived in the hospital, and we were treated extremely well with a doctors’ mess and food and drink available day and night. I did not have any student debt and I knew that whatever path I followed doctors were well respected and well paid in comparison to nearly every other profession. This was before the boom in the City. I believe that it was easy to be completely altruistic in those days.

You cannot compare the 80s to today. The intensity of every branch of medicine has significantly increased, we can intervene so much more and it can be done immediately. There were no computers when I was a junior doctor and the risk of litigation was so much less. Financially I had no student debt, it was easy to save for a deposit on a property as we were given accommodation as housemen, and there was a superb pension scheme which did not require as much employee contribution as today. We were well respected and had a great future.

Every aspect of NHS care is broken and the NHS is in severe debt. The most valuable assets in the NHS are the highly trained staff who work in it, and yet those in management seem to commit the cardinal sin of good management and not value their key personnel. For years there have been a number of initiatives under the guise of improving quality which in reality have been squeezing budgets until the pips squeaked. Clinicians have been forced to do so much more for less putting them and their patients at risk. As each part of the health service comes under pressure which it cannot handle, it naturally blames the other parts. The reality is that primary and community care is in crisis, secondary care can no longer cope, and mental health services are completely inadequate. All are drastically underfunded.

I found myself in a position where I could no longer afford to continue to be a GP partner mentally, physically or financially and resigned due to the pressure and intensity of the workload. The increase in pension contributions, lowering of the lifetime allowance, dramatic increase in indemnity fees and swinging cuts to our PMS contract made the decision quite simple. As doctors of my vintage get out, it increases the pressure on those remaining and also those possibly thinking of a career in medicine decide against it.

The junior doctors must make a stand, and we should all support them as a united profession. It will be ’our turn next’ whatever branch of medicine we are in. While I would not have supported strike action in the past, I believe that the goodwill upon which the NHS has been run in the past has probably run out. It is our duty to work together as a profession and make a stand.

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Readers' comments (14)

  • Well written article. its a shame its come to this, its all rather needless. If those in positions of authority took a stand instead of sitting on their hands the slow attrition of the profession would never have happened. lots of good people have suffered, left the profession through early retirement or emigration- and it seems a whole generation of doctors is disenfranchised.

    The author here tells it like it is. Like it actually is working on the front line, dealing with problems day in day out , having to pull oneself up by the bootstraps and keep on moving through extreme adversity. He doesnt offer meaningless platitudes either like "we must care" or "there's never been a better time to be a GP"

    We deserve better leaders and representatives otherwise we're sunk. The old guard have failed and need to leave the table......and those of us remaining need to stand together if we are to enjoy the career and future the author so believed in when he was a junior.

    come together comrades!!!

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  • I qualified in 1984 and can agree with Michael's opinion on diagnosis. But what about the treatment? With rumours about the slide towards private-run services and possibly insurance-based schemes I would like some discussion about the key aspect of the NHS we want to save because it certainly isn't any possible treatment for any possible condition totally 'free'. What we have that no other health service in the world has is, in general, no personal gain for a clinician diagnosing a particular condition and advising a particular treatment. This is what we need to campaign to save.

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  • Oh, and I forgot to add; assesment and diagnosis free at the point of need so the underprivileged aren't disadvantaged. People are surprisingly willing to put up with conditions or work out their own coping strategy but what they deserve from the NHS is an honest unbiased assesment of their problem. Whether to pay (possibly by choosing different levels of insurance -and the health insurance industry could offer far more choice and sophistication) for a particular treatment is a different decision for each individual.

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  • I completely agree with Paul Burgess. We need an honest and open debate as to what the health service should be able to provide free and to everyone. It should be open and transparent and the same across the country in my opinion. I could not agree with Dr Burgess more that everyone deserves proper assessment and diagnosis but we may well have to limit appropriate management. I appreciate that this bit might be controversial, but everyone has the right not to be in chronic pain (mental or physical), and in general have any potentially life threatening illness treated - but even this might have to have financial limits!

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