to think you'll miss your GP when they're gone...

[macdoodle]

I have been roundly criticised on other thread for trying to express this. And whilst I admit that highjacking someone's thread may not have been the best way to do it, the crisis in NHS GP is very real.
I have bee around MN for a very long time now, and sometimes the anti GP sentiment is astounding and utterly depressing.
So read this...he is not a GP (I am), but this article absolutely sums up the current problems and morale in GP at the moment.
I have been a doctor for 20 years and a GP (or in GP training) since 1999 and can honestly say that NHS GP is in very real danger of being gone very soon.
For those who continually slate GP's , please tell me what your better suggestion is, because I trained in a country with no national GP service, and it really isnt better in any way.
www.conservativehome.com/platform/2014/03/from-adrian_hilton-the-looming-manpower-crisis-in-gp-land.html

Macdoodle, I love my gp. I've been at a lot of different surgeries, with different styles if set up and different waiting times, but I have always been able to see a gp when needed. I think you all work incredibly hard, with the enormous pressure of needing to get things right.

I think people forget that to be a gp you need to keep up with medical advancements, treatments etc. so much of it is that you will be studying forever.

I do like a gp who is willing to look things up if need be. There'll always be individual differences in quality. But the service gps provide, the fact that if I have a scary pain in the morning, I can see a gp that day, and it's free at the point of entry, is an incredible, wonderful and civilised thing.

I appreciate you.

My gp is awful. I mean really awful. I've had him give me wrong advice is pregnancy, wrong prescriptions,he gave a very serious misdiagnosis to my nephew who ended up in hospital, the list goes on. I still would not be without the nhs gp as a whole though! Yes there are individual terrible gp's like mine but I'd be terrified of the whole practice being taken away.

I'm sure that I wouldn't have had children without the safety net nhs offers. I too worry for the future :(

mac you doubtless are overworked, but you did invite "why are you MNing at this moment" by coming onto MN and posting that you haven't had time to pee or make call backs - pee first, don't open MN and post that you haven't got tile to pee!

I used to have a Head of Department who'd barge into my lessons and lean on my desk if she saw through the window that I was monitoring a written task not talking to the whole class, and spend 10 minutes telling me how busy she was and "I haven't had time to pee" was a line she used regularly; I was new and held my tongue (I wouldn't now) but I just wanted to tell her to sod off and pee instead of distracting my class (was a teacher back then - another thankless job with a mix of brilliant, OK and terrible practitioners).

For those who continually slate GP's , please tell me what your better suggestion is

Double the number of GPs and charge 50 pounds per appointment (subject to some exemptions/exceptions) to deter time-wasters, and help pay for the increased workforce.

My GP is great, DH's not. My husband is waiting for his GP to write a referral for a neurology appointment since May and he sat on our passport application for three months despite us paying him to sign them.

I am going to see if I can get DH's swapped, he didn't ask for this GP he just got allocated to him when he joined.

I like the GP service generally and having lived in a country without the NHS it made me value them more however I have to say I did really think about visiting a doctor more when I had to pay.

When I injured my leg my practise were fantasic, arranged dressing changing and pretty much helped as much as they could.

Meh, I can't remember last time I was correctly diagnosed by a GP.

My last GP, before I left the UK, googled the answe to my medical issue and turned the monitor around to show me the "answer" - there are various other systems - in Germany we have a "house" doctor who os very like a GP, but can also self refer straight to specialists, and children tend to go direct to a peadiatrician for everything - it takes some of the strain off the house doctor, and means you can always get an apt on the day and get a second opinion easily.

Wow sounds like you need a break. I have just changed gp surgery as although I loved my gp she was only part time and impossible to get an appointment with. It's a large practice with 12000 patients.

My new practice is in a village and only has 6000 patients. There are more gp's employed and so far getting an appointment hasn't been a problem at all. I also got the referral that I needed that the old surgery wouldn't do. Appointments are longer too (15 mins compared to 10) and that extra time really makes a difference as the doctors talk to you.

So yes I will massively miss gp services when they are done right. My old surgery lost its caring attitude. The senior partner was very much on the 'budgeting' side of things rather than patient care and it was rubbing off on the other gp's. New surgery is a lot more patient focused.

Btw op as a nurse, I know how worried people can be about their health when they are trying to get information from doctors. please do your phone calls and home visits before being on here.

I've seen good GPs and awful GPs. Generally good with me but getting my DS diagnosed and treated for eczema and dairy allergy was a nightmare and we had to pay to go private, which I really resented.

It can be really difficult if the GP has no interest in children or it isn't their speciality. And as a mum it's horrible to be made to feel you're neurotic when you know you aren't (and I'm a nurse and bloody well knew what I was talking about).

Macdoodle I think you sound fab, the sort of GP who doesn't just tell patients what they want to hear.

I didn't realise as hcp we weren't allowed to have a quick wee and a look on mn. I do wonder how we don't all have kidney problems.

I am already missing the way things were. The GP service is already gone. I have dreaded going to a GP for years, have put things off, because I know they were overstretched. When I finally had to gwt things sorted out, I ended up having to keep going back because none of them listened, answered my questions, or told me what to expect. It was horrible. Contrast this with being able to self refer to a hospiral clinic to get things seen to by a specialist (e.g. a podiatrist) and they are able to tell me exactly what is wrong and give me something to put it right. A GP has never taken my foot problem seriously enough to refer me, so it has put me off running ans being active for decades.

My GP is lovely - when I can get to see him. The receptionist on the otherhand needs shooting. I get that she is busy but she is also an insensitive cow and is clearly in a role not suited to her. She has all the empathy of Ann Robinson and her demeanour resembles that of Mrs Slocombe.

From memory I can quote
"well if you aren't bleeding right now then I cant get you an emergency appointment, you will need to make a routine one for next month" and I am rhesus negative,
"I cant hear what you are saying for the baby screaming, call back when it has calmed down a bit" when my son who had a congenital heart defect was struggling with his blood thinners,
"well use contraception then" was her answer when I was trying to book an appointment because I hadn't had a period in 4 months.

I have also sat and watched her shout and shout for a man to send him to his GPs room when someone got up and reminded her the man is deaf in both ears so shouting him to room number whatever isn't very effective.

There are some fab GPs out there and I daresay some fab receptionists and I am in no way questioning your passion and ability to do your job but it is hard to have faith when so much experience of the GP service has been negative.

Bronya are bloody serious?? I saw 25 patients this morning, I have 10 telephone call backs and 2 house calls to do. I have about 50 results to check, half a dozen letters to send, a few urgent referrals to get off and another half a dozen less urgent. Thats before I even look at any business side of running my business with 25 employees.

It's not GPs fault the service is crap, but it's not the patients fault either. It is a political decision to run a low-quality over-stretched service to minimise cost. Not everyone can just go private because a public service is crap, some people don't have enough money left to do so once they've paid for (half of a) service through their taxes.

From the point of view of the customers, the people at the sharp-end of a nationalised service are part of a system of which politicians are the bosses. I suppose some people are to lazy or annoyed to make make fine distinctions about which layer of the state to direct their annoyance at.

I like my GP and have built up a decent relationship over the years. I have chronic health problems and it has taken a while to find the right mixture of treatments.

However it is very difficult to get an appointment with my usual GP as she only works part-time and has reduced the number of sessions she works over the years.

I do worry about what will happen in the near future as I feel GP care in this country is heading for a massive crisis. There is not enough money, not enough trained GPs, ever increasing demands and unrealistic expectations from patients (driven up by the media and politicians).

People seem to have bought into the daily mail line that all GPs are earning 250k PA and are greedy/lazy/incompetent/etc. I just don't think it is true, the majority are doing the best they can in shitty working conditions with limited resources.

All this 24/7 access is just unrealistic. There needs to be a serious discussion about what the NHS can and can't provide before it all implodes.

As a practical answer to the problem I think it is the structure of medical services that needs changing.

GPs should just be doctors, turn up, see patients and do all the stuff required to treat patients.

GPs should not spend their time budgeting and managing a practice and all that general admin - practices should be run by managers leaving the GPs to do the doctor stuff alone. The OP shouldn't be thinking about running a business and 25 employees, she should be left to concentrate on her patients.

I've worked with GPs for years, recently with a large practice. There are so many problems its hard to know where to begin.
Things get missed, mistakes are made and covered up. Very upsetting to see a patient suffer because of GP's lack of knowledge or failure to refer to consultant…of course they say its because they're so busy and don't have time but surely as professionals they shouldn't just carry on if they know their practice is unsafe?
There needs to be some kind of Primary Health Care but the GP system really doesn't work.

We lived in Australia recently where you have to pay for a GP appointment. You could usually get an appointment within a reasonable time but I only went when absolutely desperate due to the cost & missed out on prescribed medications I would normally have had here & referrals on to check things. Once I had to pay the full amount for a two minute appointment just to ask the doctor to write a letter. They had the variation in doctors you would get anywhere, some brusque, some with "good bedside manner", etc I appreciate the current system here is far from ideal but I do prefer the model where there is access for all (theoretically at least).

I categorically wouldn't miss my GP. I would miss the nurses at the surgery who have been incredibly helpful and sympathetic with my daughter (chronic ear issues), but no, I wouldn't really miss someone who is dismissive of someone only in their 30s suffering chronic tiredness and pain, who faffed about blood tests and lost results , files (even though they are bloody well supposed to be all online rather than paper now), waited for me to suggest prescribing iron for low blood counts rather than proactively suggesting it, fail to investigate things which I have then been referred to consultants for and was told by the consultant that the GP had not followed basic prescribing guidelines, claim 'dyslexia' for an ability to search for commonly prescribed drugs in BNF and refuse my help to do so as though BNF was a secret document when it can be bought easily on Amazon, told me to 'just run through' problems which friends have been advised by physios not to run with, and refused to provide or even suggest supportive bandages (because 'they had run out', I was told later- yet they did not even suggest buying one privately which I would have been happy to do) which later let to avoidable complications of diastasis, etc etc. I would much rather have a system of self-referral directly to appropriate consultants, perhaps with some initial screening by nurses. This is already available for physiotherapy so I can't see the issue with it for other NHS services. GPs are simply not competent to keep up with the range of medical conditions and needs of individuals via non-specialised practices.

And if you want to row about low pay, I am equally qualified as a GP, but am paid considerably less, and do not post on fucking mumsnet while I am at work (I am currently at home with ill child, hence ability to do so).

I have several GPs and many of them have been excellent. I like to see the same person have continuity of care. I feel sad that this is being lost.

Rather than charging patients I feel that there should be system of fines for missing a GP appointment without proper reason. The more appointments the person misses the higher the fine should be. I also feel that the fine should take into account a person's income. For example fining a single mother on income support £5 and maybe fining a more wealthy person £100 so that the fines hurt.

my private GP is so helpful, always willing to look something up or phone a colleague if he can't be sure of the answer to a question. He makes sensible recommendations that really help, prescribes the most effective drug, and is willing to investigate things that the NHS would shrug off. Obviously, I'm paying and he has more time, but it does show what things could be like.

My Gp is like that, and I've never been refused investigation for me or my dc even when the chance of something is small, and the cost high. I've even had home visits suggested by them, after their hours of work. NHS isn't doing too badly.

And if we start looking at the HNS, let me give the example of my dd2. She was born without an arm.
The NHS has provided us with 1-2 prosthesis from 6 months old, OT appointments, extra gadgets she's needs, and all sort of other things.
The statistic I was given by someone in the US is that there, the condition would not generally be covered under insurance after they were born because it was a "pre-existing condition", on average parents have paid out over $200K on prosthesis and treatment by the time the dc is 18yo. Frightening.

It's a slight aside but my concern with paying for appointments is that people who present with an initial problem that perhaps require lower level treatment may put off seeing someone due to the cost and by the time it becomes serious it costs more in the longer term.

Given theres been a lot of focus in recent years on early intervention and prevention of this seems totally at odds. However I appreciate there is a lot of time wasted in not turning up/unnecessary appointments

I don't think charging would be good either. I see my gp a lot more regularly than the average person and wouldn't be able to if I had to pay. It's not my fault I'm prone to being ill. This last month's I've had tonsillitis, had an a&e admission for kidney stones where it was found I have further kidney issues which requires a urology referral, I had to be taken off a medication after a&e visit and now I have a chest infection.

I also have a long term health condition which although not yet diagnosed I am trying to be. Awaiting my rheumatology referral for that.

It's no fun believe me.

My surgery have posters up saying how many appointments were missed last week and the cost of them to the surgery. I felt awful when I got the day wrong for my blood test appointment last week as I am now on the poster

StickyFloor - absolutely agree, the current system is so inefficient. Would be much better is all GPs were salaried and employed by the NHS so they could just get on with doctoring. There are a couple of salaried GPs with the practice I work with and they just turn up and get on with seeing patients, they get through a lot more than the GP partners.
So much Drs time is taken up running the business, admin, and meetings to discuss how to maximise practice revenue.

I am in Ireland (have also lived in the UK) and have to say I much prefer the service I get here, despite having to pay for it. I can always get an appointment the same day, and am never rushed. It doesn't compare at all to my previous experiences.
As it is, something like half the population here get free gp care, so those in poverty are not effected. Admittedly, there are people just over the threshold that will struggle though. They are talking about bringing in free gp care here, and I am hoping it never happens, as the quality of the service will inevitably drop. I think such a proposal is only sensible if it can be adequately funded, which will not be the case.

Lol at all the moaners in here. I'm from the US. This is the way the UK is headed and I promise you, you people don't know you were born!