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Dr Natasha Usher: Keep us the envy of the world

On behalf of all the GPs in this country, I would like to write to you and tell you more about what you have set out to destroy along with your fellow Conservative Jeremy Hunt. The NHS still stands as a beacon among the world, where good care is available to everyone, rich or poor, employed or unemployed. In general practice, we see everyone, no matter what their circumstance, and care for them from cradle to grave, all ages. Most days we see a mixture of prebooked patients and emergencies, and deal with all the results of tests, hospital letters, and everything else that comes our way. We try and see the vast majority in the surgery, but do still see people in their own home when they can’t make it to us. All this for what is a fairly minimal annual sum per person.

Over the last 10-20 years, general practice has taken over increasing amounts of work which was once done by hospital consultants. Our nurses support us in all areas of chronic disease management and follow up, which again a large chunk of was previously done in secondary care. We do INRs, minor surgery, immunisations, coil fitting, nexplanon, all these extra services to go the extra mile.

But something some time is going to give. We are taking on more and more work with less resources – and by that, I do not mean money. Money, yes, to pay for more staff, but if you can’t find the staff, money makes no difference. We can’t all work twice as hard for a bit extra cash, as we have no time left to spare. Equally, working longer hours is realistically not an option – at the rate and pace of work now, most GPs struggle to work 40 hours a week (which is eight sessions), never mind doing extra over and above this. And for a 7 days a week, 12 hours a day service, unless you find new doctors somewhere, you will have the same number of appointments as are available now spread over more time, but no better access, as emergency care still goes on 24/7 regardless.

I know deep down you would love to dismantle the NHS and cream off the best bits for private care. However, dismantle general practice at your peril. Look what happened to dentists, suddenly it became almost impossible to get any sort of dental care. What do you think would happen if GPs went private? Everyone would end up in A&E. And if you think demand is high now, try doubling or trebling it.

So please, Theresa May, try and fix the NHS not break us to the bone. Help make it a more attractive place to work, where we are appreciated, not just by our patients, but our politicians too. Understand how hard we work, what pressure we are under, then support us to give that service. Helps us train more doctors and nurses, and recruit from abroad to fill the gaps right now. Make our immigrants who work exceptionally hard feel welcomed with open arms. Keep us the envy of the world.

Dr Natasha Usher is a GP in Montifieth, near Dundee, Scotland