To wonder why we don't force GPs to work as NHS employees like every other doctor

I feel a bit sorry for the GPs at our local centre. They've gone to all telephone and online consults. My ds is 5, under two consultants for various issues but has NEVER seen a GP in person, they just go through my form online and prescribe/refer. Even the consultants were surprised he's never been physically seen and it's caused some issues to be missed.

They are just telehandlers now, after all that training! It must be miserable. The role they have done for us could have been a self-service AI form.

Forty!!!!! Five per hour and then all the paperwork on top. Plus, if you drop a ball it has big implications.

I imagine I would feel wrecked after a morning of that.

Hahahaha what a fantastic idea: try and pay doctors even less when the workload is unmanageable and leaving the country is already massively attractive. I just choked on my coffee.

I suggest we take the same approach with trades as well. The self employed ones need to be brought to heel and stop taking the p_ss

It is absolutely soul-destroying working in a system that is going up in flames, you're right.

Every partner I know earns less per hour than their salaried doctors. Have a look at what percentage of the week a FTE consultant spends actually seeing patients and compare that with a FTE GP partner. You'll be surprised.....

The only issue I have is where a GP is an independent contractor/business, they should not have access to the NHS pension scheme which I believe they have? Happy to be corrected if this is wrong.

Oh lordy, when I used 'we' in my last post, I was publicly stoned because people couldn't tell the difference between the collective 'we' and being accused of something as an individual (the auguement being, "i am not undertakingvthis, therefore I am not part of this 'we'")
So
Interesting to see if there is as much hysteria about the we in this post too!

But yes, GPs have always been against being an nhs employees; indeed, they were anti-nhs. The governmentchad to tie itself into all sorts of knots in order to get it off the ground (hence their being on a totally different contract/way of working)

It used to be that if you went to see a GP the problem you had, persistent abdo pain, painful hips etc etc would be diagnosed then referred to a specialist eg orthopedic surgeon at the local hospital whom the GP would write to and you would see them in a week or so. This direct line seems to have been cut and the referral letter goes off to the hospital and you are put on a waiting list of weeks, months or years.
the upshot must be that GPs are constantly seeing sick patients who aren’t or haven’t had the required treatment -through no fault of theirs.
This must be exasperating and soul destroying - complaining patients you can do nothing about.

Wes Streeting used to think all GPs should be salaried. Til it was pointed out that with all the unpaid work GP Partners do, you'd need at least 3 salaried drs to replace every 2 partners.....

A production-line of flu jabs is not the same as operating an actual GP service, at all.

The problem is that there's not enough GPs to staff more hours. It would shift hours around, but not provide more hours of service.

The people who go to medical school are intelligent, hardworking and are likely to have robust health, a high professional salary and a minimal amount of negative life experiences, save for their rigorous training and ridiculous workload (although that is their choice). Patients tend to have different lives and experiences and being labelled as rude or treated as adversaries when they are in need of assistance is, I believe, a cultural problem that causes resentment to build.

Obviously more GPs are needed to cut down on individual workloads, they need breaks and time to complete admin tasks and they need appreciation for the challenging and important work they do. Patients need to be seen, heard and treated with dignity.

Something that always strikes me as interesting is that it becomes possible for a GP surgery to be open on the weekend when they are being paid to give flu vaccinations. Maybe the NHS should pay GPs a high salary for weekend working and then more patients could be seen?

I thought that private companies like Symphony are buying up GP prractices then laying off doctors as they are expensive in favour of cheaper PAs.

@Gingernaut There are millions of jobs across every sector and industry where people work long hours. in return for higher pay than an average person.

Of course there are lots of additional tasks for a GP to work on as well as just doing appointments, but it's no different than any other job or profession. Your decorator has to go and buy the paint, do her tax return, service the van, not just paint all day. Again, it's a normal part of any career, not a GP specific issue.

If someone chooses of their own volition to take on additional work to earn more money, it doesn't make them a martyr - it just means they decided they'd like to earn some more money.

If person A chooses of their own volition to do a job of work with lower pay, benefits, career progression and so forth than the one person B chose, they're still not a martyr. They just chose which career pathway they felt best suited their needs.

And yeah, GP safety is a big issue, as it is for all medical staff.
It's also an issue for retail staff, hospitality staff, traffic wardens, hairdressers, teachers, and everyone else. Not for one single second am I saying that's right and just, but again it's not a GP specific issue.

This is intended as an attack on your opinion only and not at all on yourself personally - if it comes across as the latter that's down to my lack of communication skill rather than malintent.

And Gps have to save up, in advance, for their own maternity leave payments. They are like a private business and have to fund many things that employers nomally pay for.

Also as someone who works in an adjacent field (public health), I would never go into general practice to make loads of money (and not just in the UK sadly). Even within medical fields: the way you make money as a doctor in the UK is by making it to consultant in a field where you can also maintain a private practice.

Not to mention, one can be a salaried GP under the current structure. I believe I read that fewer GPs now want to be partners, despite the higher income, because the extra pay doesn't compensate for the workload.

British GPs are expected to do more than their equivalents in some other countries, as well. The structure of the NHS and GPs' role in gatekeeping access to secondary care places a significant burden on GPs.

I haven't read the whole thread, but I'm a DGH consultant, and I can tell you that being a GP is the hardest job in healthcare, probably one of the hardest jobs in the country. I would rather eat my own head than be a GP. Whatever they do, no one will be happy. Imagine a job where literally ANYTHING could be your next appointment. Anything of all the huge array of things that can affect the human body. It's frankly impressive that they are mostly right. It's in no way their fault that politicians chose to structure their work the way it is, or that they're not mostly direct contracted NHS employees the way I am - in fact it makes their jobs harder as they also have to be small business owners. I suspect if you tried to figure out what salary to pay a nationalised GP service, it would be completely unaffordable.

A HUGE portion of 'part time' GPs are anything but

As well as seeing patients, a GP must deal with an avalanche of correspondence from hospital clinics, laboratories and other clinical sources, reviewing and entering information onto thousands of patients' records, flagging up results requiring further treatment, messaging patients and making clinical decisions based on the results

They must help the practice comply with government imposed targets for ensuring up to date information is held on patients' height, weight, alcohol and drug consumption, prescribing issues, coding, audits and accepting new patients and all the bureaucracy that involves

They've got to make referrals to services

They must go to safeguarding, Prevent, and MARAC meetings, liaise with police, social services and community clinical services, like District Nurses and virtual wards

They must supervise and mentor trainees, reporting back ot hospitals and universities when required

They must continue with their own personal development, paying for training, conferences, memberships and exams

They are part of practice management and must help deal with hiring, firing, budgeting, procurement, security and health & safety

They must act as a duty doctor, dealing with emergencies, acting as a point of contact for admin staff, writing emergency prescriptions and offering advice

Many GPs are also part of OOH rotas, staffing Urgent Treatment Centres or specialist OOH sites

They have stepped outside the clinical career structure, forgone any chance of consultant grade to work in an isolated building with no onsite security, receiving any rando that walks through the office door, hoping the panic button works

It is a thankless, potentially dangerous, job and they are not paid enough

This.

Would the OP like to foot the bill for the thousands of GP's surgery buildings across the country?

And why, if being a gp is such a route to undeserved riches, are there only 6,311 surgeries in England when there were 7,484 in 2016?

https://www.statista.com/statistics/996600/gp-practices-in-england/

I’m a hospital doctor. You could not be more wrong.

Salaried GPs make less than hospital specialty consultants. I would leave medicine before becoming a GP, their job looks awful. They do not have it easy!

I have to say somthing here, having a chronic health condition, my GP’s are great. If I have a problem I ring they usually solve the problem. Everyone from the receptionists, secretaries, phlebotomists, HCA’s & pharmacists are doing a great job in difficult circumstances in my experience. I know not everyone’s not experiencing the same. I felt the need to put out a positive in a sea of negativity.

I would not move to Canada as a GP, they are screwed here too.

If a room is used or has to be cleaned and reset. That costs money. A practice has to cover its operating costs.

That’s very interesting! Thank you for sharing.