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'I feel guilty about leaving but it's becoming harder to do the job'

Dr Paul O’Grady, a salaried GP, explains why he is leaving a Newcastle practice to work in sunny Sydney

I qualified in 2010 and have been working as a salaried GP in and around Newcastle ever since. My current practice is in a fairly deprived urban area near the west of Newcastle.

I started to think about emigrating about a year ago. My partner works in banking and is at the point where he needs to move in order to further his career. Obviously, as a trained GP, I can work anywhere. I’d already lived in Australia for a year in 2005 during my training, so I know a bit about the system. And I didn’t exactly feel like now would be a bad time to leave the NHS.

The RCGP put a statement recently, saying they were going to make it easier for British GPs practicing overseas to come back. In my case, that actually encouraged me to go. I do feel that they’ve almost shot themselves in the foot there. I’m not due revalidation until 2018, and I’m going to retain my registration and try to stay on the performers’ list so I can come back.

I’m not planning to go to Australia long-term. I’ve got a four-year visa and a two-year contract, and I suspect I’ll stay there somewhere between the two. I don’t see myself staying there for the rest of my career, but I don’t know how things are going to go. If we settle, then it’s a possibility.

I’ve got mixed feelings about moving. I feel a certain amount of guilt about contributing to this worsening GP workforce crisis - I’ve got first-hand experience of how hard it is to recruit and retain GPs. I’ve been trained by the NHS, and there’s a part of me that feels I should be giving that work back.

But general practice needs to come to a breaking point where things bounce back a little more in favour of the GPs and the patients. At the moment it feels like the patients are getting a raw deal. It’s becoming harder to do the job in the way you want to do it - which is with continuity, spending actual time with your patients.

In terms of the work in Australia, I’ve been told that I’ll be given 15 minute consultations, with the flexibility to adapt them as I see fit. I’ve got a contract for 40 hours a week, five days a week. I’ll be developing my own list of patients, and I’ll be able to have continuity of care with the people I look after. It’s not like here, where you can end up seeing lots of emergency appointments - perhaps 30 in one morning - and finish the day feeling that you haven’t done your job properly.

My new practice is in Blacktown, about 40 minutes drive from central Sydney. I know there’s already another British GP working there already who has been there since May. It’s not too much of a surprise - I get the sense that more people here are looking for jobs overseas. A friend who graduated alongside me in 2010 is also moving out to Melbourne in October. She’s a full-time salaried GP, and thinks Australia can offer a better life for her and her family. 

There are just so many tasks that you have to do as a salaried GP, let alone a partner, and I think lots of people are thinking of moving abroad. The agency that’s helping me move certainly has no shortage of applicants.

Readers' comments (14)

  • Hardly surprised!!!

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  • sensible chap. I do agree with him. I also graduated as a GP in 2010 and have been contemplating a move abroad but wondered how it may not look good if life does not work out abroad and if moving back to the UK. Now the RCGP have made it easier to try before you buy whilst abroad. I really don't think it will help matters in the way that they have intended!!

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  • Good article.
    I am moving to Queensland at the end of the year with my husband and young son. I will be a 3/4 time GP there and I do not feel guilt about leaving the NHS. I feel guilt over what my family has had to put up with in my time as full time GP partner (admittedly now part time following the birth of my son last year- and I don't feel guilty about that either, but that's a whole other issue!). I also feel guilty about day in day out providing either a substandard service to my patients due to time pressures and budget restrictions, or being a substandard wife/mother/daughter/sister by working increasingly long hours and being ridiculously stressed. I want to reclaim my life back and, I really hope, rediscover a love of medicine. Fingers crossed!

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  • Dear Leanne,
    reading your last few lines about being substandard domestically and wanting to reclaim you life back really struck me to the core. I just wanted to wish you bon voyage and pray you do re-find your love of medicine. You definitely have nothing to feel guilty about- unless wanting to care for your loved ones and also caring for your patients has suddenly become a crime. Your decision is proof positive that we do not need to accept being CQC'd. revalidated or QOF'd out of existence. Yours is the brave decision, a decision that might eventually make the country wake up to what is happening to their most committed and brightest, and hopeful propel those who purport to represent us GPs to take drastic action to avoid the brain drain. Enjoy Aus, and hopefully your actions may herald action that leads to changes that enables you to consider returning to Blighty in the future.

    Disillusioned GP Partner(1.5yrs)

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  • Having moved from a salaried position to a partner last year, I can feel my motivation has dropped (income significantly worse than as salaried), losing enjoyment of medicine, don't feel able to relax at home, don't feel I am giving to my family what I wish.
    Exit plan already hatched, either as locum or out of the country!
    We deserve to have a life outside medicine, and it doesn't help that a significant minority of patients consider rudeness and aggression towards GPs is acceptable to get what they want, even if it isn't appropriate.

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  • Hi Paul,
    It looks like we might be work mates as I'm starting in Kildare rd in November! I can't wait!
    Chris Davis

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  • Hi Chris - that's great - look forward to meeting you and working with you then!

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  • Word of warning - I know of a friend who actually worked out in Oz for 1 year. He came back due to the costs involved, he was no better off financially (schooling, housing, health). He did find the work easier, less of a blame/compensation culture and greater empowerment of the clinicians.

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  • Well, you really think that helping the NHS "come to breaking point" by quitting, will really result in a more positive outcome for GPs and patients? Think again. I believe you're overly optimistic that there would still be a recognisable general practice service to come back to if you're still counting that as an option for your return. No doubt you may benefit by returning as an overpriced emergency locum to a crippled service, but no job satisfaction for the rest of us 50+ people still trying to mend it/mould it from within - who'll be trying to leave a decent service for everyone, when we really need it post retirement. Meanwhile, enjoy Aus, it promises to be a good move for you.

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  • Una Coales

    Good luck Leanne and Paul. Link in to the UK to Australia GP facebook group to make instant new GP friends in Aus. Remember GP is a job, it does not define who you are. You have a right to be happy, enjoy your family and work under fair conditions.

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