One of Owl’s owlets picked up a copy of a GP’s magazine (Pulse) recently and was astounded at some of the articles it contained. Here is a summary:
Front cover: Austerity for GPs must end
Page 6 – GP practices in Northern Ireland threaten to leave the NHS en-mass “unless the Government substantially increases investment”. If they do this then “many patients [will need to] pay for GP services”.
Page 6 – Practices lose six-figure sum after federation fails – 54 practices lost £284,700 after investing in a federation that failed. See also Page 18.
Page 6/7 – Chief Inspector of Care Quality Commission has his own practice rated “requires improvement” after failing to review patients on high-risk medications.
Page 7 – Capita is planning to replace staff with robots to boost profits by “taking away some of the decision-making”.
Page 7 – GPs in Somerset have been banned from prescribing a raft of medicines for minor illnesses.
Page 7 – Virgin Care wins £67m contract in W Lancs.
Page 16 – “Closing the gate before our role has bolted” – moaning that GPs are now a gatekeeper service to refer people to other treatment points, making them “deskilled and lazy” and “nodding off at the gate, drowsily waving people through”. See also page 34 for a similar story by a different doctor.
Page 18 – “Is federating putting GP practices at risk?” See also page 6. Government is still promoting these as a way of improving productivity – spending “£205m” (of our money) on promoting it. “My concern is that federations are a stepping stone towards finishing off the independent contractor status of the self-employed GP [and] large healthcare companies [see Page 7] could step in and start running them.” So Virgin Healthcare will make more profits and GPs will be paid less, leading to a shortage of GPs in the UK (like nurses and soon junior doctors).
Page 22 – “GPC bids to save ‘last man standing’ GPs” – talking to Welsh government about bailing out an increasing number of small GP practices where doctors are leaving due, with 20 practices in Wales having quit the NHS in 2016 cf. a total of 33 between 2011-2015.
Page 22 – “13 practices to close in single county [Fermanagh, NI]” “Patients will be travelling 30 to 40 miles to see a GP.” “The situation in [NI] has worsened significantly [!!!!] since reports that a third of practices will close due to retirement of a third of the 66 GPs”.
Page 22 – “Just 7% of [Scottish] GPs say 10-minute consultations are adequate”
Page 24 – Full page article on how “GPs [have to] drive patients to hospital [themselves] amid ‘scary’ ambulance delays” “Very young and elderly patients are dying because of worsening delays to 999 calls, say GP who, in some cases, have had to drive patients to hospital when an ambulance has failed to arrive.” “Underfunding of ambulance services is putting patients at risk.”
Page 24 – Government wants GPs to provide “urgent home visits”. Government wants CCGs, emergency 111 providers and local councils to set up A&E Delivery Boards to consider this alongside asking GPs to spend time in A&E departments. GPs say they haven’t got enough resources. See page 26 and 30.
Page 26 – Commissioners want to save £22bn in primary care i.e. GP services by “investing” £1.2bn. See page 24 and 30.
Page 30 – “Austerity for GPs … can’t continue” – “The primary care minister” (David Mowat) says “the Government can’t attract 5,000 extra GPs if it continues to suppress funding. See page 24 and page 26 and page ….
Page 34 “Do you want to be a musician [i.e. treating people] or a conductor [i.e. referring people]?” See page 16.
In summary, this looks to me to be a GP crisis in its infancy but growing up fast.
You have to be either especially stupid and incompetent or especially evil to create this breadth and depth of crisis so quickly.