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Dr Chaand Nagpaul: ‘These statistics are tragic’



It’s tragic that one in five trainees is intending to work overseas. It costs half a million pounds to train a GP and that’s an utter waste to the taxpayer if they go abroad afterwards.

But it’s a reflection of the workload. I don’t know from this survey where the doctors plan to go to, but we know already that countries such as Australia, New Zealand and Canada are attracting GPs from the UK.

It’s no good just recruiting more GPs if it’s going to be more than offset by those leaving the profession. It’s crucial to retain the workforce. If you don’t, the workload will become increasingly heavy and you won’t be able to attract more GPs.

But only half of GPs would recommend general practice as a career. I fought to be a GP and feel very privileged to be in the profession. It is such a shame that the pressures of the job have resulted in such low numbers of recommendations.

Unless you address what’s putting off GPs there will be a serious risk that we won’t have the infrastructure to meet patient need in years to come. A big problem is that unresourced work is continually shifting into the community. Early discharge schemes mean that patients book more appointments with their GPs as a result.

Patients need more follow-up appointments and on top of that there are more sutures that have to be removed by practice nurses. I’ve written to CCGs and told them that any commissioning change like this should be examined for workload implications.

But there is a transfer of this work towards GPs without the extra support. We need to send out a message that general practice must not be a back-stop for all these policies. Work is being transferred to general practice, expecting it to be a sponge without a saturation point.

At the moment there’s a total denial of the problems. The most important thing is that policy makers open their eyes – because the challenges experienced by general practice are staring them in the face.