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Is more of the same really good enough?



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I came back from the LMCs Conference in Liverpool last week oddly deflated.

Sure there were some barnstorming speeches and motions. GPC chair Dr Richard Vautrey said all the right things in his angry speech decrying the deliberate underfunding of general practice. A vote of ‘no confidence’ in the GMC is nothing to be sniffed at and the vote on preventing online providers ‘cherry-picking’ patients will play well among grassroots GPs.

But the most affecting speech of the day was not from the stage, but during the open mic session about workload. Milton Keynes GP Dr Sian Whyte stood up and told the room – to complete silence – about her struggles with burnout after becoming a partner.

How she paid for psychotherapy herself and managed to keep working. Then how she hit rock bottom after the loss of a much-loved colleague who ‘left behind two children and a husband to walk in front of the train to Euston’.

GPs should not have to hit rock bottom to get support

She ended her speech in tears, saying: ‘What really makes me angry is that I don’t need to become more resilient – I need you, GPC, to change the environment in which I work so that I don’t need to.’

I spoke with her afterwards and Dr Whyte said that she wanted to shine a spotlight on the issue of burnout at the conference. It was an incredibly brave thing to do and she deserved every minute of the standing ovation that followed her speech.

You may be aware that Pulse has campaigned long and hard to raise awareness about burnout and mental exhaustion among GPs and for better help and support, which the NHS is now providing. There is greater awareness than ever about the pressures on GPs and it is good to see the BMA trying to address this with new guidance on safe limits for patient contacts (even if applying them in practice may leave you open to a contract breach).

But Dr Whyte touched on something very important. GPs should not have to hit rock bottom to get support. They should not have to develop thicker skins in order to cope with the day job. The status quo is harming doctors and needs to change, but there is little sign of that on the horizon.

Scotland has a new deal, there are some promising signs in Wales, but we are heading for yet more of the same in this year’s contract in England: some small-scale tinkering with a slight bump in funding.

There will be a crunch vote this week about whether to accept the deal. Although I understand there is some disquiet among the GPC about it all, with some protesting behind closed doors that a more radical approach is needed, it is still likely to go through.

The only radical change is a review promised on the QOF and perhaps some movement on premises costs. The BMA is pushing for a 2% pay rise for partners, but we will not know about this until the summer.

But negotiators still have no answer for the charge that Dr Whyte laid at their door last week – that they are failing to ensure the safe working of their profession. That will take some careful renegotiation of the GP contract and a clear vision of how to ensure that limits on workload can be applied without risk of contractual sanction.

And there is no sign of them coming up with that any time soon.

Nigel Praities is editor of Pulse. Follow him on Twitter @nigelpraities