The coming year presently does look rather bleak and I do hate to be so pessimistic – but it is important to remain realistic about the current state of affairs. Deal or no deal, it is going to be chaos.
It only takes a bit of snowfall for the nation to go into a state of panic, with stockpiling creating shortages in basic commodities. I only shudder to think what Brexit could do. We have to face up to the prospect of scrambling for essential drugs and equipment, further staff shortages and being caught up in political unrest at a time where pressures are already high.
The Department of Health already struggles to provide optimum resources; rationing is likely to become sharper post-Brexit. Those who are vulnerable, frail, sick with long-term conditions or living in poverty – how will we supply the demand when we already cannot meet it?
On a more positive note the push for prevention and education is giving me hope that we are now focusing our attention more on cause rather than effect. Many including the RCGP, the British Society of Lifestyle Medicine and Dr Rangan Chatterjee have pushed this health and wellbeing agenda to the forefront and I believe this will only continue to gather momentum in the coming year.
I predict more and more GPs will be opting for portfolio path
However, morale in the GP profession is at an all-time low, especially among partners. I predict more and more GPs will be opting for portfolio paths, something I welcome because it is an evolution for survival; GPs cannot sustain longevity of career or health with the way things are currently going. Moreover, sessional GPs bring diversity in skill sets to primary care as they are able to juggle management roles, training and integrating care with secondary teams while supporting their partner colleagues.
In Scotland, however, I worry about the role of sessional GPs as they currently have no input or place within the new GP contract, which is designed to be partner-centric. More and more GPs are attracted to sessional and portfolio models of practice across the country, with workload being only one component of that decision-making process. There is a disconnect between the vision behind the contract and a workforce that is becoming increasingly diversified. In 2019 we may see some backlash from sessional GPs demanding a more equal place at the table.
Despite everything, a lot of work will continue to be done on raising awareness of the health and mental wellbeing of doctors everywhere. We must all try to remain positive, hopeful, mindful and supportive of one another, our profession and our overall duty to serve and care for those who matter the most.
Dr Punam Krishan is a sessional GP in Glasgow