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

I'm a hospital consultant and do not envy my friends who are GPs, they are much more stressed and less supported than I am, they certainly don't make the amount of money the media seem to think they do. Even if they did I don't think comparisons to other high stress jobs are necessarily fair, there aren't many other jobs where you make life and death decisions everyday. It's very hard to let go, I still wake up worrying in the middle of the night and all the doctors I know can remember every mistake they've ever made.

Yanbu, I never go to my gp as I feel sorry for them.

"Jeremy Hunt is not reading this"

This. Sadly this.

Agree with LumiersForMe's post.

I would miss my GP ALOT. Out of the 25 GPs I've seen so far, only 2-3 were not nice, the rest have been fab.

Macdoodle- one of my ex GPs was convicted of sexually abusing several patients in his surgery.

Do you actually want me to sympathise with a rapist, and his professional colleagues who protected him and allowed the abuse to continue for years?

He was allowed to carry on practicing after there had been allegations against him. The GPs closed rank.

Even after he was convicted he didn't even automatically have his medical licence revoked. The gmc (ie other doctors) actually allowed him to argue his case to continue practicing after his release!!

A 'profession' which operates like this deserves to be dismantled.

My gp surgery is run by a married couple, I love them to pieces they are intelligent, sensitive speak to me like a human being and always make my dc laugh during appointments. They always take my concerns seriously and if you have a emergency they will squeeze you in to be seen that day.

Demand is going up, people want to see their GP more often - funding is going down, any surprise what the end result is?

I already am missing it tbh. I've got an ongoing issue that although affects my day to day life I don't feel is 'important' enough to go and argue my case for. It's painful and draining, I just haven't got the energy to fight the nhs on top of that.

I've recently moved and not bothered registering with a new gp yet, partly because I know in my case that I'd have to present x number of times for it to be considered an issue and I just can't bring myself to play the game whilst feeling like a hypochondriac and time waster as I'm told to see how it is in a couple of weeks.

I do think there's a couple of things gp's could do, it would to take need to take generational differences into account though when looking at the uptakes. I would love a kind of webmd diary to document my symptoms for a month or so then submit to be reviewed either to have a gp appointment, tests or referral.

I'd also be prepared to pay for certain investigations. If I need bloods or a ultrasound I would happily pay for that directly and if I meet the criteria for a referral do it without ever setting foot in the surgery. Even if the rest of a patients pathway is nhs funded it would save a few quid surely. Especially in the age of dr google. You're either reassured it's not what you think or you're on your way to being sorted out.

I've often thought Lloyds chemist would make a killing offering tests for viral/bacterial colds.

The majority of people just want to feel better not be a pain in the backside.

I don't know what I'll do if/when my GP surgery is gone. They are absolutely amazing, every one of them. Every GP I've ever seen there has gone above and beyond for me and one of them quite literally saved my life by taking me seriously at once when I went in with serious depression. I'm ok now and I rarely use the service, but if it hadn't been there back then, I'd be dead. The idea of a future where that service doesn't exist is really frightening.

Picking up on weatheralls anacdote, doing a good job doesn't necessarily make you a good person.

Fwiw I know a lot of clinicians across the nhs who I love dearly and have seen first hand being absolutely amazing. I have also witnessed utter bastards who shouldn't be in any job involving the well being of others, I wouldn't trust them handing me a milkshake from behind a KFC counter never mind being responsible for the state of my health.

Refusing to acknowledge the outright awful shit that goes on allows it to keep happening by excusing it under the banners of overwork and stress. The profession needs to weed that shit out if they want to have their complaints to have real public support.

I would miss my local chemist more.

The GP problem in this country would be helped if we used the NHS properly e.g. Don't go to your GP or a&e first, go and see a pharmacist. I've been doing so for the last 10 years (&2 kids) and have seen a GP 3 times - shingles & 2 6wk checks. Not everything needs to be seen by a GP.

Though I was astounded that the first appointment I was offered to see a nurse for my annual contraceptive check was 32days away..... Christ only knows how long I'd wait to make an appointment with a GP!

In the 20 years I have worked in this area one local hospital has expanded its consultant physician number from 4 to 33.

My surgery, in the same time frame, has increased by 0.5 of a GP full-time equivalent. While the list size, complexity of problems, demand (fuelled by politicians and a v hostile press) and care from hospital being transferred to Primary Care (with no transfer of funds/resources of course) rise and rise and rise.

My 30 hrs part-time job (I have kids) is now approx. 50/wk.
My take-home income (which was NEVER 100k pro rata) has gone down.

I had about 60 pt contacts today, ranging from 'I woke up with a sore throat this morning and need to be seen at 10.30am because no other time will suit my busy schedule' to 'I am a fiercely independent elderly lady with a terminal cancer and I cannot cope but I will NOT accept any kind of help' and everything in between.

I am registered with a neighbouring practice and yes, access is sometimes difficult. There is lots of work to be done and is being done, but it will only work if we all feel we have something to lose if the NHS/Primary Care goes.
I don't understand why GP are seen as 'them' and then there is 'us' - I am a GP but also a patient and I will be eternally grateful and impressed what the NHS has done for me and my family.
DS2's NICU care would have cost a 6 figure sum - many standard insurance schemes would not have paid out for what he needed at the time.

I have lived and work in countries with only private healthcare, a mixture of state-run and private systems, and insurance systems. And for the last 21 years in the UK.
I know where I'd prefer to seriously ill (I'd prefer NOT to be seriously ill, but YKWIM).

I work in a v varied area and some of our more affluent patients are under the impression that they will get better health care privately and that is simply not my experience. Yes, they'll get seen quicker, the waiting room is going to be plusher and the receptionist is likely younger and more attractive . They may even get what they want, but not necessarily what they need. Harsh, and authoritative and maybe authoritarian at times, but true.

I cannot tell all of you how glad I have been in the last 5-10 years to be working in Scotland and not England where there is clearly a concerted effort at work to destroy Primary Care/the NHS by using a very business and profit-maximising model of health care which I find morally wrong and deeply offensive.

I am a GP.
I'm sure most people have heard the oft quoted statistic that GPs do 90% of the NHS work with 8-9% of the budget.
We are not specialists- we openly admit we don't know everything about everything. We hopefully know enough 'red flag' symptoms to recognise when something is serious.
It would cripple the NHS if we referred everyone with abdo pain for example. We HAVE to use the watch and wait option.
Remember too that we have no access to immediate scans and bloods which inform so much decision making in hospital.
Mentions of pay on here are grossly overestimated. Add to that the medical indemnity/ GMC fees/ other professional fees we pay and we are not well paid considering our years of study and debt accumulated in that time.
Our days are whirlwinds of seeing patients, visits, phone calls, blood results, letters, admin. I could work 24 hours a day and not meet demand.
OP- I get your frustration. It's so hard to face criticism when you're doing your best, working beyond capacity and everyone else you know is too.
I'm sorry some of you have bad GPs and make no excuses for the not listening. I think listening and hearing patients real worries is one of the most important things we can offer.
Thanks to all that are understanding about waiting times , imperfect service and all the flaws in the current system.
And to those who feel dismissed- please go back, don't let symptoms progress or worsen.
Sorry this has been so long.

OP. you sound angry. And a bit scary. Meant kindly: time for a break?

Just to say that it doesn't have to be all or nothing for the NHS. You can find a middle ground between them. I have family who live in Belgium. They pay up front (last time I asked, was about £15 I think) for each appointment, and for medication. They are then refunded according to their income, so you pay more of the actual cost if you are rich, and less if you are poor. Dentists are the same. You can register with any doctor within a reasonable distance. You can self-refer to specialists and costs are reasonable. I go to visit if I need any serious dental work (had a root canal after the last baby) as it is less than half the cost of here, even with me paying the full bill. The care is also fantastic, e.g. for cancer treatment you will see a specialist within a week then would be operated on/start chemo in a week to ten days. As far as I know it's paid for through taxes, but you have to have separate insurance for hospital stays. Nothing like the US system though.

I love the principle of the NHS, and wish we could make it work. If we can't, perhaps we should look around Europe and pick another model to try. There are a fair few to choose from!

I've had good GPs and not so good GPs. There's one reasonably good one at our practice and, since this year, you have to wait weeks to see him.

Pacific and Rainbow

I'm not sure that the 'you chose this career' or 'other people work hard too' type of comments are helpful - if your terms and conditions changed weekly/monthly and you had no say in it how would you feel?

Tbh I feel sorry for all the GP that end up working in shit conditions.
The ones on MN and the ones in RL.

What really don't understand is why people have a go at them for 'nit being good enough' instead of having a go at all the politicians that have created this crap system. Thus us really a situation where people are shooting the messenger! :(

The real question is how can we improve the system so GP have more time and more resources to come to the right diagnosis?
There are so many possibilities here. Sending people to a consultant earlier, having more GP, having a real private sector (we don't really have one or the one we have isn't a workable option, not at £120 the 15min consultation with a GP).
What I don't accept is the fact we are paying as many taxes as before but now have a system that really only cater for real emergency situation (eg your heart attack) but nothing else (eg people with chronic condition discharged from consultant to be followed by GP that don't have the knowledge to treat appriately or don't want to do what the consultant says as it costs too much, they don't want the responsibility fir very serious drug etc)

Lumieres I refer you to the answer I gave some moments ago - demand going UP, funding going DOWN, it's that simple.

Maybe it should all start by acknowledging the NHS isn't doing as well as it was even 15years ago.

And that the NHS isn't this fantastic thing everyone envies Britain for.

Especially when you see the number if people who go abroad to get the care they should get at home :(

I am not a GP, but I have spent almost my entire career in primary care research and, until recently, I worked part time as a practice manager in a medium sized practice in the South of England.

20-odd years ago my life was saved by a GP who correctly diagnosed a rare cancer and got me a referral very, very quickly.

GPs today are disillusioned and over-worked. However, a small proportion of them blame the patients and patient expectations. Whilst the days of the GP as a god are long gone, we do need to remember that they have gone through a lot of training and have a lot of experience that we, as patients, do not have. I say this as someone who has a degree in Biochemistry and a PhD in Medical Sciences and a career in Health Services Research.

This Government has stretched general practice to its limits: causing nearly 100 practices to close in the last few years (Pulse) and many GPs to take early retirement or emigrate. Practices lost at least £30K last year through changes to QOF and, in its stead, they have been dumped with the new DES which tries to get them to predict who will need an emergency admission. This pays practices £20K, but costs far more.

What seems to be forgotten is that practices are independent contractors - small businesses in other words. They cannot survive without an income. They cannot employ people without an income.

General practice is in the mess it is in today because of this government. They promised no top down re-organisation of the NHS, then promptly gave us one: yet NHS England local area teams are becoming the SHAs, the CCGs the PCTs.

They sacked/made redundant NHS managers - then had to re-hire them when they realised that they did a good job.

They gave responsibility to GPs and other clinicians who know nothing of NHS management - then wonder why it's all going tits. If you want a doctor to be a doctor, then let them.

Sorry if this is rambling. I'm actually dosed up on tramadol at the moment following a car accident in which myself and my DDs were cut out of our car following a collision by the Fire Brigade. We were then blue-lighted to A&E by 2 Ambulances. I was then operated on by the NHS whilst, luckily and thank God, my DDs were less seriously injured and discharged by the fabulous staff after a couple of hours. I was then in ICT for a week, after which I went to a general ward. I'm now home. We have all seen our GP in the last few weeks and feel supported and cared for.

The bottom line of this story is that we are lucky to have this NHS and we won't realise it until this government has sold it off completely.

The difference between rural and city practices perhaps accounts for some of this?

I went from having a GP in a rural area to when I moved to the city, a GP in an inner city practice (or as inner city as Scotland gets). I LOVE LOVE LOVE my GP in the city. You can get a same day appointment if you phone up at 8, I have never not got one. The doctors are patient and friendly (receptionists not so much, but if you smile at them they are OK). The practice I go to is a bit "all human life is here" so they understand lots of conditions, aren't judgemental, try always to help you out and are very patient. My GP is a combination of practical and kind, she's much in demand as she has these qualities, but truthfully there isn't a doctor in that practice I'd be unhappy seeing. I think they have an excellent service and they have helped me through many bad times with my mental health too (which gets a bit shaky).

In the country, the GPs were waaaaay overworked with a massive patient load. My GP there (he's retired now) pretty much chucked pills at you until you went away and was quite judgemental from my own experience and what others who went to him told me - MH problems, stop whining! Contraception, women are supposed to have babies aren't they? Addiction, pull yourself together! The contrast is night and day.

I also love the NHS and want to keep it. It is a thing the UK should be proud of and we should do whatever we can to defend it.

lyndie I agree.

In my work, I see a lot if people who are ill now and are going through the system now. Situation has become horrible in the last 6~8 months. In direct link with the recent policies on the NHS, budget cuts etc (so sctually the demand might have gone up but the government has decided to bring the budget down instead).
But the system itself can be made to work much more efficiently and that would start by remodelling the whole NHS. However it seems no one is ready to do that, maybe because the NHS is seen as such an institution (see the place it got at the opening ceremony if the Olympic Games for example)