What are GPs actually doing right how?

[Darkchocolateandcoffee]

I've just been talking to my 84 yr old mum who can't get a GP appt for love nor money and is worried what she does next as she has a serious condition that she needs to talk to the doc about.

I love 100 miles away from her but I haven't been able to get a doc appointment for my children for months either.

One had such severe hayfever all through the summer and the only appt I could get was with my GP surgery's pharmacist over the phone, who sounded very unengaged and said the only remedies were OTC ones despite me saying we had tried all of them.

I eventually gave up and did a one-off private GP appt and got him prescription meds which worked straightaway. But I wasted weeks beforehand in which he was suffering trying to get the same thing via our usual GP.

Everyone I talk to says the same. The rest of the NHS seems to be firing on all cylinders.

What on EARTH are the GPs doing instead?

[quote TataMamma]@BoredZelda
Accept there are problems with underfunding and other matters, but: it is a fact that before Covid people could mostly get face to face appointments and now it is impossible because GPs prefer not to. That is the point, even if there are long term issues at stake, Covid has been a cop-out where they now don't see patients at all, ever.[/quote]
That is not true at all. There were massive problems well before Covid with people in many areas struggling to get appointments.

Our GP practice is wonderful.

I have seen my GP when needed during the pandemic, and had phone calls when these have been sufficient - for myself and the DC.

I haven’t heard of NHS GPs taking payment for appointments

Then I'd suggest you're very fortunate; as I've mentioned on here before, my previous GP is using the telephone triage system to tout for private appointments in NHS time

And before anyone says it again, yes it's been reported (nothing done) and the media approached (won't touch it as it doesn't fit the current "NHS heroes" narrative)

I'd be utterly amazed if this is the only case of it happening, and wonder how long it'll be until the needle swings and the issue receives wider coverage ... except I don't kid myself that anything will be done about it then either

@JinglingHellsBells. Do you really believe that GPs should do nothing in life except work and chores? With that kind of crazy, unrealistic patient mentality I’m not surprised most medical students are thinking screw that and pick a different speciality or opt out of medicine altogether. We should be encouraging more medics to become GPs which we won’t if they are personally blamed for a failing system.

Oh and PS. I know lots of people who earn over £100k (work in finance) and no one only has time for work and chores. If they do, then they’re obviously not very good at their job or avoiding spending time with their families.

My GP is absolutely fab.

I do everything through e-consult;
Prescriptions are done within 24 hours (sometimes same day)
Phone appointments within 2-3 days.
F2F appointments within a couple of weeks.

One day I was waiting for a phone appointment, it got to 6pm so I thought he'd run over and would ring the next day instead. 10 past 8 the phone rings!! Couldn't believe it. He is so genuinely lovely that I actually felt awful speaking to him so late and apologised profusely, he told me it was fine but my god - he's been in that building since 7am.

So no, it's not ALL GPs. Don't tar them all with the same brush just because your local provision is completely overwhelmed/not doing enough, because it's definitely not the norm.

Everyone demanding that I write to my MP about ‘underfunding’: I assume that you haven’t read the full thread.

I’ve seen a number of posters complaining that people don’t want to become GP partners in practice, for a minimum 5 year term, in exchange for a payment of £20k. So clearly it’s not a money problem. Or is it? I don’t suppose that the GP representative bodies are trying to hold the government to ransom to get a generous settlement, are they? No, surely not! When has that ever happened before?

Spoiler: 2004.

How is extra ‘funding’ for general practice going to help? Precisely? More money for individual GPS, or something else? If the latter, what? I added the inverted commas because I’m ex-NHS senior finance. I dealt with representatives of GPs and other clinicians every day. The people using the word normally don’t think about what ‘funding’ means. It’s usually code for “give me, personally, more money and the problem will go away”.

Here’s an extract from a post upthread:

do you know what I think is unfair? The fact that every single time the government ask GPs to do something, we get our heads together and we do it. Even though it often results in a pay cut for us.

How do you work that out? People in ordinary jobs don’t complain about ‘pay cuts’ when they are asked to do more. As a GP you are either salaried, or you are a partner in your own business. If the former, there is no way that your salary will have been cut. If the latter, then as the owner of a business - and a well-remunerated owner at that; many GP partners are earning north of £100k - you take the rough with the smooth. You don’t divide your pay by your hours, compare it to last year and decide that you have had a ‘pay cut’.

We’ve also been informed on this thread that older GPs are retiring because of ‘GP bashing’. Really? It couldn’t possibly be that their generous NHS pension pots have hit the magic £1m, and that they don’t want to either pay the tax on the excess or leave the NHS pension scheme, could it? A bit like the consultants crying about ‘paying to go to work’ who have figuratively taken their ball home in protest by refusing to work as many sessions as they could until they are given more tax-free money?

I don’t think GPs are lazy. Far from it. However I object to being fed propaganda about them being angelic beings whose only care is for the health of their patients, and that the wicked government is stopping them from healing the sick. Bollocks. They are like the rest of us, and in common with the rest of the doctor population, are not averse to fighting dirty in order to get what they want: more money.

I can’t feel sympathy for any GP whilst my 89 year old mother, who cannot “go online”, is forced into a ridiculous game of fastest finger first each morning, trying to get a GP appointment for her genuine health needs, and calls me crying tears of frustration about hours wasted on the phone with still no appointment to show for it.

'I genuinely don't understand how the GPs on this thread have the time to be on a chat forum! Sure, you aren't all working full time. But the people I know who are at a similar level (educationally and responsibility) in other fields, and on £100K a year simply do not have time to browse forums even on their days off.'

Does seem weird that they'd either have the time or the inclination tbh. In the past when I've had a busy demanding job the last thing I could be arsed doing would be logging on to mn for a debate/argument.

It's like teachers who are soooo run ragged but spend hours arguing on here. Gives a snapshot of time management and prioritising skills imo.

@HunkyPunk

If they are driven out of their profession by an angry mob then the situation will only get worse.

No angry mob, just a lot of scared people wondering what the implications of a broken healthcare system are for us all.

Some of the commenters are scared and dealing with poor care. But many of the comments are angry and ill informed. I referred to an angry mob because it is the Government that has been egging this along to keep the blame on individual doctors because if people realised this was the govs responsibility their popularity was take a massive hit. Who do you think allocates money and resources it this country?

Attacking doctors until they all leave and the system collapses will leave us all worse off too.

@Rainydaypuddles

Our GP practice is wonderful.

I have seen my GP when needed during the pandemic, and had phone calls when these have been sufficient - for myself and the DC.

Well that’s great. For you. How about all the elderly people for whom it’s not working? Who is speaking up for them?

Accept there are problems with underfunding and other matters, but: it is a fact that before Covid people could mostly get face to face appointments and now it is impossible because GPs prefer not to. That is the point, even if there are long term issues at stake, Covid has been a cop-out where they now don't see patients at all, ever.

People have been complaining about a lack of GP appointments for years. And in the last 18 months, more have retired, and fewer have replaced them. They will also have Covid and isolating to deal with among staff. Prior to Covid you could pretty much only get F2F appointments and that was a real problem too. The current system works better for a whole lot of people. My GP offers both, and you can usually be seen within the week, or on the day for urgent appointments, same as I could generally get an appointment when I needed it pre-Covid. But I’m not so naive to think there weren’t problems elsewhere.

In any event, to suggest GPS have suddenly just sat back and said “this is great, we can just not see people and still get a wage, instead sit with our feet up” is laughable.

Try the pharmacist. The GP couldn't see my child this morning but the pharmacist was really helpful.

How about all the elderly people for whom it’s not working? Who is speaking up for them?

How about all the disabled people who for years have been asking for things like phone appointments as it makes life much easier for them, who was speaking up for them before?

Ours is back to normal
Turn up at surgery hours , see receptionist, say which Dr you want to see, you’re given a number

Wait
See Dr
The only difference is that you wait in your car in the car park , and the Dr comes out with an A4 piece of card with a number on and you then go in and have your appointment

Yawn. It’s tragic that you want to dictate what doctors and teachers are doing in their down time. Everyone in this country has the same legal entitlement to holiday. By your own implication your life must be pretty poorly managed if you have the time to come on here and complain about how others do their jobs.

Does seem weird that they'd either have the time or the inclination tbh. In the past when I've had a busy demanding job the last thing I could be arsed doing would be logging on to mn for a debate/argument.

It's like teachers who are soooo run ragged but spend hours arguing on here. Gives a snapshot of time management and prioritising skills imo.

It’s almost as if different people have different ways of coping with their busy, demanding jobs.

I have ( unfortunately) had to speak to my GP with a variety of issues over the pandemic,resulting in 3 separate 2ww appointments. My family have collectively had the worst 2 years health-wise that we've had for ages,but the GPs have been contactable by phone,and doing face to face appointments as needed , both me and my adult daughter saw GPs. Probably not all through first lockdown but for a long time now. Everyone has been nice as well (and when I rang in in tears after surgery earlier in the year the receptionist got a doctor to ring me back within an hour)
I realise we seem to have been very lucky,but our surgery has bedn great.

'How about all the disabled people who for years have been asking for things like phone appointments as it makes life much easier for them, who was speaking up for them before?'

Exactly. I know many Deaf people and econsults have been fantastic, no more akward and frustrating minicom conversations using text relay (that receptionists bizarrely do not seem competent with), no more waiting for relatives or interpreters to speak on their behalf, often very private information that the Deaf person would rather not have a third person knowing about.

Econsults mean gps have more time to see the people that need examining.

If that's the case why don't all these greedy GPs just move to the private sector?

Perhaps because some prefer to take the NHS money and whatever extras they can screw out of patients during their NHS time? After all plenty already do private work too, and that works as long as the demarcation's in place - but it falls down if they get greedy and feel NHS time and money should be used for it too

As a PP suggested, we've gone too long with the "all doctors are heroes" smokescreen, when actually they're people like everyone else and some bad ones will slip through. As ever, the difficulty arises when nothing's done about this because too many (including doctors themselves) seem to think they're untouchable

I’m guessing when we all have to start paying £60 per GP appointment when it’s privatised totally that everyone will be happy then? (I’ve lived in countries where this is normal and yes you can get a same day consultation with the doctor of your choice).

Also the IS where you have to pay for cancer treatment? That’s where the conspiracy and anti vac stuff comes from as they believe vaccinations make you ill/get cancer/MS so you go to the doctor to pay £200k for chemo.
GPs want to stay free at the point of care, but if they are fully privatised then they’ll actually be better off financially and emotionally. No GP I know is on £100k

It's been really hard to get an appointment where I am. The receptionist won't make appointments over the phone, we have to book it online and I found the whole process very complicated so I dread to think how some elderly people are finding it. I also really dislike the way I to have to write on the booking system the reason I need an appointment because there's a lack of confidentiality as it goes straight to the receptionist to read. I have trouble talking about the issue let alone writing it down for all the office staff to read. Everyone I know and spoken to have all had problems seeing a GP.

'I’m guessing when we all have to start paying £60 per GP appointment when it’s privatised totally that everyone will be happy then? (I’ve lived in countries where this is normal and yes you can get a same day consultation with the doctor of your choice).'

It is a disappointing fact that people seem to be much more organised when they are working privately. For example a friend works in a private hospital and they'll whip through 6 or more knee replacements per day. In the nhs it's 4. The same consultant. There's no incentive for them to work faster when it's all nhs work sadly. They can go as slow as they want.

Not all doctors are like that obviously but it does seem these hard pressed run ragged drs who can't cope with nhs demands and stresses suddenly become time management experts once they can see the £££ rolling in.

Or maybe the theatres in a private hospital aren’t suddenly taken up with an emergency and the procedure has to be delayed or postponed?

I’m guessing when we all have to start paying £60 per GP appointment when it’s privatised totally that everyone will be happy then?

Well, I expect some doctors will be happy

As you say, as a body they voted against charging for appointments, but unsurprisingly it wasn't unanimous, so it's entirely likely any charging NHS patients on the side were to be found among the "yes" vote

@MissLucyEyelesbarrow

The population is growing.

The population is ageing: so they have more complex health needs.

The number of GPs is falling - by fifth in the last 6 years

The UK has a very low number of doctors per head of population: about half of many EU countries.

There has been a global pandemic so hospitals (through no fault of their own) have had to suspend many services, meaning that this work falls to GPs.

Primary care is chronically underfunded: even before the pandemic, GPs did 80-90% of all healthcare for 8% of the NHS budget.

Somehow, the right wing media has convinced dimwits like the OP that this is all the fault of GPs 🙄

Very well put.