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What does a GP do when they lose their patience?

Reports that a GP has literally downed tools and quit his role have rocked the region of Greater Manchester.

Citing a post-Covid deluge of pressure, the father-of-two simply ended his 15-year-tenure with the words: ‘Nothing ever changes, I realised the only thing I can change is myself.’

His combustible frustrations are shared by doctors, nurses, and non-clinical staff across primary care, and his statements about treating people for mental health issues whilst battling your own really resonated.

For the would-be GP, a career where red tape, filling in for dentists, being an advocate in industrial disputes, preparing for endless inspections, signing fit notes (even for children so as to preserve good attendance records), finding accommodation for the homeless, softening the pain for patients awaiting elective surgery, managing mental health because services have been decimated, and carrying out oxygen tests within the home is no longer an attractive option. Especially when you can do it lucratively overseas and with better conditions.

Then there’s the day-to-day which never went away, whether it’s by phone or in person, patching up patients who take little or no responsibility for their own health.

The buck has been well and truly past from secondary care, and with pharmacists similarly beleaguered, no wonder I feel like screaming every time I hear the phrase: ‘Ask your GP about…’

As someone who’s stood on picket lines for junior doctors and lobbied politically for everyone from paramedics to porters, you would think I’d be in favour ‘direct action’ like walking away.

But for me personally, there’s a bigger picture here, and precedent to prove that together we can succeed where the individual alone cannot.

One of Covid’s few positives is that the public has finally seen the value of their health service. This, then, is the opportune time to tap into that sympathy and raise the plight of their local practice. That window may be short, and there will come a time when instead of beating their pots and pans on the doorstep in support of us, they will instead throw them our way.

A few minutes’ PR engaging with patients, encouraging them to see the surgery as their own and perhaps playing their part in a Patient Participation Group would help. As would taking our provision out to others, staging food banks, distributing sanitary products to the poor… When a community believes it’s their GP surgery, they support it even in the face of draconian cuts and negative publicity. The days of the austere GP have gone, and it’s important that we demystify the family doctor and replace that image with the true human, in-touch, and professional individuals that we are.

And instead of being defused by headlines about the next pay rise or the symptoms that we should have seen but missed, we must keep on talking about our worrying situation with the concerns of the public our top priority.

When the voters are on your side, the politicians must listen.

There need to be active voices for the profession that reach out to other branches of health and social care and indeed decision-makers at local authority level. Over the past months here in Oldham, we’ve created health zones, where nutritional food and exercise provision is present, and we and held the first Covid vaccination clinic for the homeless. Why? Because we got our opinions heard at the highest level.

Essentially, the battle ahead requires courage. I believe that our colleague in Bury has shown enormous self-sacrifice in a bid to heighten awareness and preserve his own sanity. But for me, the resurrection of the surgery, so badly damaged by everyone from the legacy of Shipman to the machinations of this current Government, lies in the hands of we GPs standing and fighting, using our weight within our communities, and utilising our collectives tapping into a zeitgeist where health matters.

Make no mistake, the surgery is of course in trouble. The entire system of primary care could be about to collapse. The Government should set reasonable expectation levels – but seemingly won’t. All of that should be our call to arms, a clarion shout to staff the barricades and fight, rather than surrender. I honestly believe that our patients value their local practice and their family doctor. And it’s up to us as GPs to make sure that they still have one.   

Dr Zahid Chauhan OBE is a GP in Greater Manchester, founder of the Homeless-Friendly charity and a campaigner for health equalities.


Chris GP 7 July, 2021 11:35 am

Poor sod , but I am sure the right and brave decision. To you a longer and happier life awaits. I have read the Manchester news article – my advice to any that have yet to do the same – don’t read the comments that follow it…it is like a form of distilled Dail Wail bigotry. Convincing this (?) minority that there is value in primary care is going to be difficult.

David jenkins 7 July, 2021 1:49 pm

well done !

come to locumland, where life is much rosier and you can control your workload. on monday i left the house before 8 am (largely to avoid school traffic), drove almost 20 miles to work, and was cheerfully greeted with a coffee. i saw 40 patients throughout the day, and got home at about 7pm.

it was hard going – but it doesn’t matter, because i had time off yesterday.

i did one “ganfyd” letter – for a 91 year old who had to cancel a weekend break (hospital appt).

no qof, no silly meetings, no interruptions from administrators, just go to work, see patients, go home.

all the staff and patients are very grateful. and i know i’ll get paid within a week.

if any surgeries take the p*ss, or dump on you, just don’t go back – in 14 years that hasn’t happened.

Patrufini Duffy 7 July, 2021 3:23 pm

I read about compassion fatigue.
The NHS is not smart. You drag someone through a gutter, and encourage effluent to be poured on you with your mouth open, will make some (*sadly only some) wake up. Your time between now, and your inevitable death on planet Earth is your choosing. Choose wisely moving forward. And healthily.

Sam Macphie 9 July, 2021 1:46 pm

And they said the NHS is “open for business” during the pandemic, which does not give the complete picture because it is not open properly: one of the biggest NHS and Government
lies, deceits of the pandemic even if it a good little soundbite. Also remember all the closures of practices and closures of A and E s , reductions in hospital wards during the last decade, as examples of poor preparation for a Covid pandemic. Will this Government build extra A and Es , increase the numbers of NHS beds and hospitals, increase the available ICU s in all areas after this pandemic: or have they learned nothing?

Vinci Ho 10 July, 2021 7:35 am

I fully respect where you come from :
(1) As I wrote a few days ago under Jaimie’s editorial , the ‘right’ thing can only be done at the right historical circumstance, at any other time and place , it can become the ‘wrong’ thing .
Hence , my inference from this belief is, there is a fine line between audacity and stupidity . And I suppose that is also the case between righteousness and hypocrisy.
(2) I am not too sure about the ideology of ‘zeitgeist where health matters’ . Health issues always matter but running systems are often flawed to make them matter , especially in NHS which essentially becomes a religion in this country ,whether one likes it or not . The undeniable success of Covid 19 vaccination programme in this country led by GPs(don’t think anyone can dispute on the this ) simply demonstrates how poor the insight government(s) and its propaganda machines have had about the true worthiness of GPs . The way GPs being neglected by successive governments , prior to this plague , had created a ‘malnourished child’ characterised by a disease called Recruitment and Retention syndrome .
(3)Yet , ironically , the malnourished child had saved the day and now the prime minister and its government are planning a presumably monumental day on 19th July 2021 .
Yes , majority of us, GPs , have been sacrificing selflessly. In fact , I have come across numerous colleagues who are far more selfless than I could imagine during this historic disaster . But there is a limit to everything and everyone , I am afraid. The number of colleagues who were burnt out or even burnt away was substantial. Current RCGP president-elect(unopposed) , Clare Gerada, would be more than grateful to supply evidences acquired from the practitioner health service she was involved .

I think it is politically correct to say that all our innocent patients need our best effort to take them out of this miserable plight of Covid 19 and its aftermath.
But it begs the question , who and what are actually helping us(GPs) to help them ?
‘Help me help you!’ ( famous line from Tom Cruise’s wonderful movie , Jerry Macguire)
I do not think many politicians understand the true meaning of this ……….🧐😑
Vinci Ho
General Practitioner
PCN Care Enterprise clinical director
Liverpool LMC committee member
GMC 3483114