Why don't we just train more doctors?

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The UK has had a shortage of doctors for decades now and we have relied a lot on using doctors trained overseas.

I understand that it's expensive to train doctors but it's clearly a lot more expensive to not have enough doctors and have to pay locums at locum rates.

It's also a lot more expensive when people are unable to work due to waiting sometimes a year or more for medical treatment that will let them get back to work.

Lots of people make the grades for medical school and there is no shortage of applicants, nor has there ever been.

What has been the blocker to training more doctors, I just don't get it?

I don't think they really are giving return of service after a couple of years work when you consider how much doctors have to pay for their education in other countries - it takes the best part of their working lives sometimes.

It’s not ‘a couple of years’ to independent practice
have you not read how long it takes to train as a GP and years longer to become a consultant

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im very unlikely to be called in but if I rarely was - maybe once a year- I wouldn’t be paid any more, no, because it is quiet the rest of the time. This is monitored intermittently.

but I think I’m definitely worth more than £2 an hour to be at the end of the telephone. I think everyone is worth more than that.

it’s absolute nonsense

Re ease of appointments, I think the rot set in during the early noughties. I got married in 1997, can't remember problems before then. We either rang to book an afternoon appointment which would be maybe a week ahead, or we turned up and waited during the morning "open" surgery.

But mid noughties, it had become a nightmare, with long phone queues, the "open" surgery had stopped, so all appointments to be made in advance, no longer a choice of GP, you were allocated randomly, and that's when the waiting times increased to a few weeks.

I think the rot for our surgery started with the retirement of the GP partners - there were two of them who'd been there forever who both retired in the early noughties, then it was a carousel of random GPs.

No shouting down from here. Why would you make your work/life balance worse and end up with no extra money, greater stress and fatigue, and less time to yourself? The amount of time you are spending on work is as much as many people do who consider themselves in full-time employment.

The whole system is a mess.

They pay quite a lot in this country too - it certainly isn't free and certainly isn't a couple of years. I think five or seven years minimum and often far longer seems a reasonable request.

I pay for lawyers, accountants, engineers, teachers, social workers, dentists, politicians and many others to complete degrees - why should they not give back in the same way? Should people who attend FE colleges on vocational courses that I help fund pay some of that back by working in the public sector - plumbers making sure they spend a couple of years in hospitals, schools and council offices sorting their ancient plumbing? Why should doctors be singled out - particularly when the vast majority do spend most of their working life in public service.

Far better we offer incentives and rewards to encourage people to stay practicing medicine. Perhaps write off student loans, change the training so that they can settle and build a life somewhere, pay a reasonable wage for the level of responsibility and resource hospitals and GPs well enough to let them feel they can provide a good service. Perhaps vote to fund our health service at a level comparable to other developed nations?

Most doctors in other countries are working in the private sector. Most countries pay their doctors more. Luxembourg offers around £240K for a newly qualified GP. Belgium is around £115,218. In the UK it is £60,455 for a full-time salaried GP. Perhaps we should pay them more.

Thats just anecdotal, for you and your GP practice, the rot set in the mid 00's - my experience was completely different.

The point i'm making is that generally speaking, this country has had just about enough GPs and Doctors, thats no longer the case.

We certainly never had 7m waiting for treatment and a Govt promising a F2F appointment within 2 weeks, Labours target was 2 days and it was, in the main, met.

It'll get worse too, in terms of retention, not least because the doctors qualifying now feel very short changed because their contracts are worsened since 2017. Those people will soon qualify.

No one has mentioned the various changes each Gov has done over the last few years. My BIL (a former GP, since retired) fell about laughing at the ridiculous generous package they received in 2007 (Was this Tony Blair or Gordon Brown?). They were basically paid more to do less.
Changes to pensions, etc have meant that many now retire early, and my BIL has since moved to France to avoid the high tax here on his very generous pension.

Yes, anecdotal re my practice, but I'm old enough to remember all the "save the NHS" messages from the 90s and 00s, Blair/Brown's two NIC rises to "save the NIC", the front pages of newspapers "24 hours to save the NHS", blair's ruinous GP contract in the mid 00's that was promised to "solve the GP shortage crisis", Blair/Brown trebled NHS spending over their 12 years in office.

So it wasn't just "my practice" was it? Blair wouldn't have been making speeches extolling the virtues of his new GP contract to "solve the GP shortage crisis" if there wasn't a problem back then would he?

Yes, I've no doubt things have got a lot worse over the past 20 years, but the NHS had serious problems in the 00's too!

The NHS has been in "crisis" ever since I can remember!

Have you NC'd Kazzy ?

Yes the NHS has never been up there with european health services but it was never like this in the 00's.

I used the Royal Berks a few times back then plus GP's too for some stomach issues & it was far superior, as i said, the max wait for GP appts was 2 days, its now 2 weeks and they want to bin that, despite it being just a few weeks old.

I don't know about the GP contracts, Blair certainly did nothing for dentistry but its worse again, the only NHS dentistry in my county is emergency only, i wonder if GPs will go the same way.

I'd really like to know what public service has improved over the last 12 years?

I'd really like to know what public service has improved over the last 12 years?

Certainly none in Scotland, unless you count money being spent on unnecessary stuff like baby boxes and child top ups.

Don't forget that money is being diverted from other services.

Is it unreasonable to query whether if more consultants, trained in the NHS, stuck to NHS work rather than private, they might get through the NHS waiting lists quicker?

My colleague went private for a hysterectomy and saw the same consultant six months earlier than she would have done, had she waiting for an NHS appointment.

Yes but that procedure would have been done in a private hospital.
A consultant needs scans, nurses, theatre time etc etc.

The irony is that as the NHS fails, more people are going private, hence more work for consultants and other healthcare staff who want to leave the NHS.

Just imagine if those nurses and other medical professionals, no doubt trained in the NHS, carried out the work for the NHS instead and better use was made of the theatre time. I was shocked when I recently went to the hospital to be asked by the receptionist if I was "an NHS patient today". Does that mean private healthcare is making use of NHS facilities?

But you are musing the point that the nhs does not want to pay for that consultant’s extra time in which they are doing private work. Anyone is free to do whatever they want in their non- contracted time. And the NHS pay has meant a 35% pay erosion since this government has been in office.

I don't know the answer to that, but if they are, they'll be paying the NHS Trust for the use of those facilities.

But taking up places in that NHS queue.

And the appointment was half an hour late (should have been 8.30 am) because there was no consultant available in order for the clinic to start. But I'd been waiting a few months anyway for the appointment, so what did another half hour matter.

As others have pointed out, to go ahead with a clinic and certainly with an operation, you need a lot of people to be available at the same time, as well as the facilities. It must be a nightmare to schedule, especially at a time of worrying staff shortages. Clinics often run late if the staff have been dealing with an emergency.

This would mean changing their contracts and paying them more as they would be doing more work for the NHS than they do now. I'd be happy to pay more tax to help sort out the NHS but the majority of voters in this country want magicians, not politicians, in power - they want more and better public services but they also want to pay less tax.

If you read the Higher Education section you will see how hard it is to get accepted to study medicine. Hundreds if not thousands of very very bright motivated students who can't get a place to not only be taught to uk standards but who know and understand our culture. Meanwhile we will import students from other countries who potentially are not as well qualified and do not know our culture. We then have to quite often house them and their families. It's a ridiculous situation imo.

I agree, cosmiccosmos . It puts pressure on existing doctors, and is no doubt intended to. 20% of graduates not employed last year.

This is a very simplest way of looking at things. A lot of consultants are doing full time NHS work and doing private work in their spare time. Some of this spare time will be within 9-5, because they would have compressed their 40h week into fewer days.

In our trust, additional surgical and endoscopy lists occur at the weekend, because the the lists are all full during the week. In some cases, there isn’t enough theatre space for new surgeons to run a list. The patient may also need ITU beds to recover in post-op but these may be full and, so surgery will need to be cancelled and so the back log quickly builds.

20% of graduates not employed last year.

This is incorrect. About 800 final-year medical students were not allocated to foundation training programmes in the first round and were placed on the reserve list. This was a higher number than in previous years. By April, however, all of these had been allocated places.

I'm not sue they can be compelled to work much more over their contracted hours. The NHS doesn’t own their staff - although it feels like people think they should sometimes.

Should a shop assistant stop working at a food bank to work more than their contracted hours in the shop? Or a PE teacher not be allowed to referree at weekends?