Graphista
If there's a GP shortage (and I too think a HUGE part of the problem is too many part timers who were more than happy to accept the investment in their training & happy to accept the high salary but unwilling to provide the service they were trained FOR - don't even get me started on the fact that most won't work outside office hours EVER, nor bank holidays and the ludicrous length of Christmas/winter closures)
This is just rubbish. And yes, I am a Doctor but not a GP.
There is no IF about the GP shortage. It's a fact. There are some area's where the shortage has a signficant impact than others- e.g. rural areas and area's with high poverty, for instance.
As for the "part-timers" being the problem- are you seriously saying that all Dr's must work full time? Why should they- if there is a shortage that is down to poor workforce planning and/or difficulties retaining staff. If it's such a cushy job for enormous pay, you'd think that everyone would be falling over themselves to do it. Yet, they aren't..... I can guarantee you there are reasons for this.
And you do know not all consultants or associate specialists (or even nurses, pharmacists, physio's, OT's, psychologists and so on) work full time. Nor are they obliged to, contractually or morally. If the NHS does not want part-time staff they aren't obliged to employ them. But it does allow people who also happen to be Dr's or other healthcare professionals to work around children/caring responsibilities.
In relation to your criticism in relation to out of hours working- I wonder if you are aware of the background as to how that came about? Apart from the fact that some GP's clearly do work out of hours at weekends/nights/bank holidays (who sees you in out of hours GP??)- and in our area this is largely GPs who have opted to do some shifts and also work in local practices with the odd one or two who solely work for out of hours service. The reason it was taken over by 111/out of hours was related to government policy at the time of a contract negotiation- essentially the Dept's of health across the UK thought (incorrectly) that they could provide out of hours more cheaply than by paying the GP practices to do it- so they incentivised GP practices to hand over the responsibility (some GPs still do provide their own OOH services- though this is in very rural areas). Add in the increasing day-to-day workload (multifactorial) and wanting GPs to take on additional duties from secondary care, with the beginnings of a shortage of GPs, and they recognised that without changing something, there were going to be issues with providing day-to-day services.
That is not to say that all GP surgeries are well run- some GP practices are not functioning efficiently. Some are in crisis as they are so short of GPs (and practice nurses) with an increasingly elderly population with multiple co-morbidities and more complex health needs etc.
I agree some things could be done better- e.g. having direct access to physio/podiatry in your GP surgery. Interestingly, this is something the new GP contract in Scotland is aiming to work on with money being put in to fund community physiotherapists, based in GP surgeries and who can be booked directly by the patient through the surgery- no GP referral needed. There is some concern that patients who probably don't need a physio appt (e.g. have had a sore back for a few days) may end up taking the appt.'s unnecessarily and a physio triage (by the physio) has been mooted in some areas.