THE head of the Royal College of GPs yesterday said that the job of full-time GPs was now ‘undoable’ owing to the huge pressures of work.
Professor Martin Marshall said it would be wrong to think that younger doctors were more workshy than previous generations, but he said, ‘I think what this signals is that the job of a GP is now undoable on a full-time basis. The idea that we can see 50, 60, 70 patients a day, five days a week, is crazy.’
Professor Marshall was responding to new research by The King’s Fund think tank which polled 840 trainee GPs about their future medical career intentions.
Trainee GPs are already working in general practice but who have not yet become fully qualified as GPs.
The poll revealed that only one in twenty planned to carry on working in general practice within ten years of qualifying. The majority indicated that they intended to work part-time between one and a half to three days a week.
The actual number of trainee GPs is in fact at an all-time high, with a total of 3,538 doctors taking up training posts this year. But this increase is clearly threatened by these trainees facing the incredible workloads and the associated pressure on them. This means that thousands more are needed.
This fantastic increased workload being placed on the shoulders of GPs is usually rationalised away by the Tories as the inevitable consequence of a growing, ageing population making more and more demands on the NHS and on GPs in particular.
What has been ignored is the effect of privatisation on GPs, a form of ‘creeping privatisation’ of general practice that has seen private companies being handed contracts instead of them going to groups of GPs.
The Tory Primary Care Act, passed just before the general election, introduced a new type of contract for GPs, the APMS (alternative provider of medical services) which opened the gate for the entry of a new ‘model’ for GP services.
This model did away with the old concept of GP partnerships driven by the medical needs of the community they served and replaced it with a profit-driven ethos.
With GPs now allowed to opt out of out-of-hours appointments, private companies rushed in to grab large contracts to provide phone advice and home visits. Local GPs were encouraged to form consortia to bid for contracts.
In both cases, profit-driven companies took hold of traditional GP services.
Trainee GPs no longer had the prospect of becoming partners in GP practices as in the past, but were now facing a future as employees of the private companies and consortiums.
The Health and Social Care Act passed by the Tory coalition in 2012 went further in allowing non-NHS organisations like Virgin Care to expand and take on chains of surgeries.
When these private companies fail to make a profit they simply pack up and walk away, leaving local GPs to pick up the patients. This happened in Brighton in June 2016, when the private Practice Group terminated its contract for five GP surgeries and left 11,500 patients looking for a new GP!
On top of the creeping privatisation of general practices of course has been the open massive austerity cuts and privatisation of the rest of the NHS, with hospitals and hospital beds being closed on a massive scale.
All this has increased the pressure on GP services, as NHS England champions ‘care in the community’ as an alternative to hospitals and specialist doctors. At the same time, NHS England has been promoting the use of artificial intelligence by private companies offering smartphone apps and on-line consultation if patients register for a fee with them.
By registering with these companies, the patient is automatically dropped from their original GP list and becomes part of the private companies’ registered doctors.
The issue of GP services cannot be dealt with outside of the demand for an immediate halt to privatisation of the NHS and for the privateers to be kicked out completely from every part of it.
This can only be done by expropriating the private health companies, and nationalising the giant pharmaceutical companies under a socialist planned economy.