The position for general practice is absolutely dire. There are practices that cannot recruit or are grotesquely understaffed, and demand is soaring.
Physician associates remain an unknown quantity and only six physician associates from the USA have actually been recruited for an NHS pilot, so any evaluation will be at best inaccurate and at worst misleading.
If scarce resources are to be invested in a UK-trained PA workforce, we must be sure they can deliver.
It would be an error to think GPs are replaceable; even in a 10-minute consultation they perform minor miracles that would be hard to replicate without the skills, continuity and trust that UK GPs have.
If a PA can earn up to £50k a year and a GP partner is on £100k – though few of those are left in London – they have to deliver at least half of what a GP partner does, or do it in less than twice the time or the money is wasted.
But if PAs are a short- or medium-term solution, are you going to be diverting funds, expertise and impetus from that absolute need to increase the GP workforce? We can’t just re-plaster a damp wall.
My concern is that PAs can only do so much – the dwindling GP workforce will still have to do most of the work.
Dr Tony Grewal is medical secretary of Londonwide LMCs
