The Doctors’ Association UK has sent a new book written by its past co-chair, Dr Ellen Welch, to every Member of Parliament and to the chairs of NHS integrated care boards. The aim: putting general practice at the top of every manifesto in this 2024 election year. The book, Why Can’t I See My GP – The past, present and future of general practice, published on 8 February, does not mince words. It outlines the current problems in general practice, how it has reached this point, and what needs to be done about it.
Medscape News UK interviewed Dr Welch, who is a GP in Cumbria, about the state of general practice in England.
Medscape News UK: What is your assessment of the present situation in primary care in England?
Dr Welch: Things are dire. The facts and figures show that staff are working hard to keep services afloat. GPs carry out 1.4 million appointments a day. We’re delivering 20% more than we did pre-pandemic in 2019, and that’s more of everything: face to face, same day appointments, home visits, telephone consults… Despite that, we have less funding and fewer staff. Since 2015, we’ve lost around 2000 GPs and over 1000 GP practices have closed. Primary care really does hold the rest of the NHS together and we are seeing problems throughout the rest of the system: lengthy waits for ambulances, seven million people on waiting lists, corridor care, and people waiting longer for emergency care in our emergency departments. And what is becoming increasingly apparent is that this situation is by design. The government are repeatedly disinvesting in NHS general practice, and as the service gets ever worse, they are spinning a narrative that erodes patients’ trust in GPs and attributes the problems to the very staff trying to keep the service afloat.
Can you offer some views from other GPs, quoted in your book, about how they view general practice now?
There are many, including:
“It’s really tiring trying to provide a service to patients who you know deserve better and to continue to work in a service where poor care is being normalised.”
“The reality is we do not have enough doctors.”
“There is a constant feeling of being on the back foot and daily firefighting.”
“General practice is elbow deep in a recruitment and retention crisis.”
“We need NHS leaders to see that making ineffective changes and essentially forcing fewer GPs to work even harder will lead to a future of practices opening long hours but staffed by a succession of non-partnership staff who have little knowledge of their patients… I would be lying if I said general practice is not at a crisis point, but it is salvageable if those in charge are prepared to listen to GPs.”
Are there significant variations between the situation in different regions, such as urban and rural?
I think GPs face similar issues across the UK in terms of demand, funding, and staffing, but certainly different areas face different problems. A GP in central London may have a different set of concerns to a GP working in rural Cumbria. This is one of the reasons we’ve sent a copy of this book to all UK MPs, to inform them of the main universal issues, but also to encourage them to go and visit their local GP practices and engage with their local medical committees to find out what the specific problems are in their areas.
What are GPs’ main fears for the future?
That the government will deliberately undermine NHS general practice by starving it of funds, eroding patients’ trust with a negative media narrative, and allowing it to collapse to give way to a private healthcare system.
What needs to change to build a better future?
Quite simply, investment. Staff are burnt out and undervalued, and many are leaving the NHS. Many who have gone abroad have done so for the better pay, conditions, and lifestyle. But if we invest in the service, then we can rebuild a better future.
Have you had any significant responses yet from the MPs who have all been sent your book?
Not yet, but we will be following this up in the coming weeks. We have also sent a copy to all 42 Integrated Care Board chairs.
You say that media headlines frequently misrepresent the day-to-day reality of a GP’s job. Can you give an example?
A prime example is from during the pandemic when what I’d call the propaganda of the pandemic was that GP surgeries were closed, whereas the reality was that GPs were working harder than ever. They did move to conduct many remote consults, but they also established hot hubs overnight so that people could still be seen face to face. They delivered the COVID vaccination programme. This particular media message was so strong that many GPs reported a common scenario of having a patient sitting in front of them, being examined in person, yet asking them when they were going to be open and seeing people again.
Welch disclosed that all book royalties are being donated to Doctors’ Association UK.
Source link : https://www.medscape.com/s/viewarticle/british-government-eroding-primary-care-purpose-2024a10002m0?src=rss
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Publish date : 2024-02-06 15:53:44
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