I feel that Dr Phil Peverley perfectly captured the mood of the time and spoke for hundreds of GPs in his recent column (The tale of a spurned lover).
He says that if the NHS had treated him right it could have had his services for life, but it hasn't. So like a spurned lover, he is leaving – or, at least, considering going part time. I too feel constantly on the verge of resigning.
I am 56 and could go at any time. I still have vocation, I still care about my patients and my excellent staff, and I still do an excellent job as attested to by just about any measure you
care to look at – patient satisfaction, surveys, low A&E attendance rates, low emergency admission rates, low referral rates and high conversion of outpatient attendance to follow-up.
The demands of the job, though, are rising. As well as having to deal with an increasingly anxious and sick society, ever more is expected from us in the identification and management of chronic diseases.
It has been suggested that 15- to 20-minute appointments are more appropriate for dealing with the extent of what is expected from a consultation, but where are the time, manpower and finances coming from to allow this to happen?
The Government is constantly harping on about increasing quality in general practice, yet is unwilling to pay for it.
How does the NHS reward me for my hard work? My take-home pay has dropped 23% in the last two years. I have had half a day off sick in 25 years.
I hardly have any holiday – I struggle to get two weeks off a year because of the cost and unavailability of locums. And study leave? Forget it!
The Government has orchestrated a campaign to denigrate GPs in the national media. The Care Quality Commission quango will be poking its nose into my practice and no doubt demanding costly and pointless changes.
And to cap it all, there is the threat of being found unequal to revalidation, and the retirement age being pushed further backwards along with a smaller pension at the end of it.
In the same issue of Pulse, RCGP chair Dr Clare Gerada said she is anxious about undergoing the revalidation process. If she is at risk, who is safe? If a significant number of GPs fail, who is going to do their work?
Who is going to pay for locums – if they are even available – and who will pay for the retraining? Who is going to run the retraining, and will they know more than the experienced GPs they are meant to be improving?
And if a shed-load of senior doctors decide they've had enough and retire, just who is going to do their work?
There is no doctor better able to look after my patients than me, and yet after 25 years of the prison sentence that is general practice I feel threatened with rejection.
I have looked up my pension entitlement now and at various stages until I am 65.
I predict that with the current rate of decline in my take-home pay, there will be a point in the not-too-distant future when I will actually be better off not working.
Similarly, Dr Peverley is considering going part time and I expect many older doctors will do likewise and vote with their feet.
Where will the Government's precious NHS reforms be then? In our area, only senior doctors are involved in commissioning. When they go I can't see it remaining viable.
What will the Government do then? Bring in the private companies to run commissioning? What will that cost? More than paying a few public-spirited GPs to do it for peanuts in time squeezed between other working commitments, I'll bet.
The public love the NHS – as well they might. They trust doctors. They won't forget or forgive in a hurry the party who led to the downfall of the NHS.
GPs are notoriously bad at sticking together and fighting – look at the fiasco over the pensions dispute. So I call on young GPs to think about their future. Is your job going the way you want it to? If not, do something about it. Protest. Save the NHS, because now more than at any time in the past I feel it is in real danger.
In a sense, Phil and I are irrelevant. We've done our time. But what of your future? What sort of NHS are you heading for?
From Dr Paul Harris, Sprowston, Norfolk
