GPs will leave in droves while the parties play politics with the NHS

http://www.theguardian.com/commentisfree/2015/apr/15/gps-parties-play-politics-nhs-taxation-health

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The pre-election headline du jour is that a third of UK GPs plan to retire in the next five years due to stress and unmanageable workload. The British Medical Association (BMA), which conducted the poll, is not unaware that an election is looming, and its publication now is a highly political act that has already been seized on by the opposition parties. But is it true?

Most of the GPs who said they were going to retire in the next five years were over 50. Only 5% of GPs in their 40s were considering retirement in the next five years. Some will doubtless retire early because they’re burned out, but others will be making a lifestyle choice after weighing up their pension and ability to take on other paid work. The question is whether a similar proportion of the public would also seriously consider retirement within five years if they had the resources to survive and thrive. I’m guessing yes.

There does seem to be a shortfall in recruiting new GPs relative to the optimistic target of 3,250 trainee GPs per year set by the NHS taskforce last year. People may be deterred from going to medical school by university fees (the last year of the five-year course is funded but you still have to cover living costs and don’t start earning until you’re qualified). It can’t just be the thought of hard work that puts junior doctors off general practice. After all, hospital medicine is hardly a bed of roses either. Perhaps it is partly the relentless drip feed of stories, some of which are put out by the BMA and all of which are exploited by politicians, about how hard life is as a GP.

In some areas, general practice is an incredibly hard job. The cash injections of the Labour governments had started to dry up even when they were still in power. There was an improvement in funding; most went into increased resources and some boosted GP pay. But there was a price to pay: increased targets, much more responsibility, and a shift of workload from secondary (hospital) care to the community. That would have been great, except that community services such as district nursing, health visitors and community midwives all but dried up. And the promised melding of social and health care never happened, so elderly people with multiple problems are kicked out of hospital, half dead, to be “cared for in the community”. The only person left standing in some areas is the GP.

It is still possible to be a GP and enjoy your job. I do. But I work in Barnet, which has an outstandingly good clinical commissioning group (CCG) run by local GPs who are doing their level best to commission appropriate services. Even the best CCGs struggle, however, as they are the instruments of government rationing, which is rather like letting the turkeys run the abattoir.

In my practice, we serve a diverse but stable population and levels of deprivation are low. In 25 years of practice, I have never been bored, and it remains a fascinating, meaningful and mostly rewarding job. The spectacle of politicians bandying around our healthcare system for political gain is nauseating. The BMA cannot really be blamed for entering the fray; after all, it is a trade union. But the sooner we can fund the NHS from ringfenced taxation and protect it from political interference, the better for all of our health.