To ask where have all the GPs gone?

[Lolacat1234]

Got sent to an "urgent care walk in centre" by 111 today because my 3 year old daughter has a high temp and was very unwell earlier today. Got there and very soon realised I had been sent to A&E, there is no such thing as an urgent care walk in centre, it's just another name for A&E. Sat there for 6 hours before deciding she needed sleep and her own bed and that I would try my GP surgery in the morning. Please no comments about I should have stayed, when I left there were 25 people ahead of my daughter and I had already been there 6 hours, she had lost it and was having a breakdown. My instinct said it was OK to leave, dose her up and reassess in the morning.

As I was leaving (I was the 3rd mum with a sick child to give up and go within half an hour) the receptionist just said they can't manage an out of hours service at all because there are no GPs. My friend I was chatting to told me her local surgery has no GPs at all just nurse practitioners and they bring them in from another local surgery if needed. It all seems very scary.

Where have they all gone?

@RosesAndHellebores - neither DH or I are British. DD lives in Brussels and DS in Amsterdam - we no longer have any ties to the UK. Following Brexit we didn’t want to stay in the UK. We moved to Canada as DH is French Canadian and has a medical license to work there. French is my second language so it was easy for me to transfer within the firm I work for. These were are our reasons for moving, not so DH has an easier working life.

@Parker231 then perhaps you shoukd stop slagging off what was your host country and its government. Presumably you experienced many benefits when living here otherwise with your intellectual and cultural privilege you wouldn't have done so. There must have been significant benefits to stay as long as you did.

Of course it is. It was actually 40,000.

@Parker231 I hope your new life is great and your DH is getting on well. I have lots of friends that went to Aus / Ca "just for one year" and they never come back!

Shocking that you've been told that, as an immigrant of sorts, you're not allowed to criticise the working conditions and should just accept and indeed be grateful!

Presumably criticism is only by those who have been hugely wronged by being called by their first name many years ago and for the indignity of having to request their thyroxine script 6 times a year instead of 4.

And you're the one accused of being self-righteous!

@privateandnhsgp - thank you. Our move is (hopefully) a forever move - couldn’t cope with another international move especially with the dog and cat!
Am missing being only a channel crossing away from my parents in Knokke-Heist in Belgium and DD and DS in Brussels and Amsterdam but on the plus side we’re exploring DH’s old haunts and have found some lovely new restaurants and coffee shops. We’re booked on an architectural walk next week - our area is like parts of Paris.

I am an NHS professional so can pretty much take care of myself but I nearly died recently because I was unable to get any help from a GP for weeks.
In the end I just went to A&E and was admitted after hours and hours but it should never have got this far.

Not this again

My OH went to his GPs dozens of times over a few years but was just constantly fobbed off, told he was "just stressed", told to take more exercise, etc., for his symptoms of general bone ache, severe headaches, passing out, etc. It was only when he was seen by a random locum that she ordered a different blood test - she clearly suspected something but didn't say what. A few days later, she phoned him back saying she'd arranged an appointment with oncology the week after. Turned out it was a rare bone marrow cancer, that was apparently "rare" in younger people, the haematologist said she'd seen quite a few "younger" patients with it and it wasn't as rare as GPs thought it was!

she'd seen quite a few "younger" patients with it and it wasn't as rare as GPs thought it was!

Sorry about your oh and hope he’s on the mend. Nothing is as rare as GP’s think ime. There were 3 bowel cancer patients <50 in my ward despite my GP saying it was “one in a million”.

I was also told they only see one case of bowel cancer per GP per year (in any age) to try and justify why it wasn’t uppermost in their mind. My actual response to that would get me banned - this being the most common type of malignancy in the UK - but “what the bloody fuck do they do all day?” sums it up.

Useless articles.

It isn't the most common malignancy in the UK - you're talking bollocks.

Many partners are stopping being a partner as it's just too much. And a salaried can't apply to be a partner. Last week I worked 8-7, popped home then went to a partners meeting 7.45-11pm. No work life balance and exhausted.

And a salaried can't apply to be a partner

nonsense

My cousin bought into a partnership over time, so I know it's possible.

4th most common @privateandnhsgp according to CRUK.

Out of interest, dyou think that excuses GP missing it over about 30 appointments?

Yes, glad we're agreed that it's NOT the most common.

In terms of your particular case, without knowing what was said at those "30" consultations, I have no idea.

Of course, it's entirely possible that your GP was/is incompetent. There are incompetent people in every walk of life.

Our local oncology unit has recently missed two cancer reoccurances because they failed to check the results of scans that they requested. Patients now being treated palliatively when there may have been another option.

Incompetent? Yes, certainly. Do I need to generalise this to all oncology units everywhere? No, of course not. That would make me a fucking idiot.

I get the stuff about being overworked etc but kind of think it doesn't get you a lot of public support to say you have no choice but to retire early because your pension is worth a million ££s.

Sigh. That's not what I'm saying. Did you read the posts at all?

Doctors are receiving unexpected five figure tax bills which is a tax on the hypothetical growth of their pension pot in a year. They are being taxed on money that they will never receive. In some cases, doing a single extra session per year can tip you over a threshold and cost you thousands. And this tax has to be paid out of already taxed income.

It's nothing to do with the lifetime allowance.

The amount of shit being spouted on this thread as fact by people who have absolutely no idea how GP is run or what a GP does is staggering and exactly why no one wants to so the job. The sooner its over the better, I will always have work but you will never get GP back

Are GPs allowed to advertise these days offering private services. It's very convoluted finding one?

Just Google "private GP near me". We have several. I don't earn much but I've paid a couple of times recently because I needed treatment and at the NHS surgery I'm registered with you fill in an online form, wait six weeks for a call back that you miss and then fill in another form and repeat. So you never actually get seen. The private clinics are open though. Presumably that doesn't give them too big a pension, I dunno. Ofc it means you're paying twice, once through tax and then the full whack clinic fee, but you do get seen.

Something we voted on in 2016 had a big impact ----> "More than 4,000 European doctors have opted not to work in the NHS following the Brexit vote in 2016, research has revealed. According to analysis from the Nuffield Trust health think tank, the pre-Brexit number of doctor specialists working in the NHS in 2021 was forecast to be 41,321" From Bloomberg.

In terms of your particular case, without knowing what was said at those "30" consultations, I have no idea.
Of course, it's entirely possible that your GP was/is incompetent. There are incompetent people in every walk of life

What was said from about the fifth appointment on was "I've noticed that I have all the red flag symptoms for colon cancer and according to the guidelines I should be referred for a colonoscopy. Here they are." Prior to that it was "I am losing weight and bleeding". 30 appointments across 7 GP's btw, 3 of whom were partners. (I can be very precise because it was all given as evidence in the negligence claim, which I won). Nobody my age gets colon cancer apparently - tell that to Deborah James' family. It is inexcusable and "incompetence" doesn't begin to cover it.

I am not extrapolating to all GP's (although I have yet to consult with a competent one), but I am saying this is not uncommon and it will continue to happen as long as some egotistical idiots who can't entertain the idea of being wrong hold the keys to secondary care.

The same gaslighting bullshit happened with my severely autistic son's need for a pediatrician. And my request to be referred for genetic testing (which I was also right about - I have Lynch syndrome, which would never have been diagnosed if I had not insisted and would have left my DC at risk of inheriting the faulty gene).

I am fortunate enough to have lived in 4 countries including the UK. The health systems in all of them were superior to "our" NHS and only one was fully private. Interestingly, only the UK has GP's as gatekeepers. I am firmly of the view that GP's are the cause of the delay that means our cancer survival rates are so piss poor. I will not mourn their demise because it's hard to envisage that the alternative would be worse.

So you're not extrapolating to all GPs (by the way "GPs" has no apostrophe) but actually you are extrapolating to all GPs.

That's fine, it is your right and you've clearly been traumatised by your experiences. I'm not sure that I believe you that you had a further 25 appointments with classical symptoms and weren't referred, but that's by the by.

The vast majority of GPs that I've met and worked with have been appropriately competent, and I suspect I've met more than you. Doesn't matter either way.

In terms of cancer outcomes, reducing what is a very complex multifactorial issue (there are huge secondary care issues in terms of imaging access, access to medication treatments, lack of oncologists, lack of radiotherapists etc) to one part of the system is exactly the thought process that I would expect from someone that knows nothing about the provider side of healthcare and primary care in particular.

But then that's exactly the same conclusion I came to the last time we had this discussion although I think that was several name changes ago for you.

Also I forgot to say, in terms of the Lynch syndrome, I've never worked anywhere where such a referral to regional genetics would be initiated in primary care. It should have been undertaken by secondary care on getting your diagnosis, and they should have specified any suggestions for familial screening at that point.

In fact, the only time in my career that I've had to do such a referral is when it's been forgotten by secondary care.

But of course, I'm sure that's your GP's fault too.

I don’t think we’ve ever debated on here @privateandnhsgp - I’m quite new to MN posting-wise although I’ve lurked for a while. You do realise that more than one person might disagree with you about certain topics?

The fact that you are more concerned about apostrophes than an appalling misdiagnosis by a member of your profession tells me everything I need to know about GP’s (Sorry, my phone insists… 🙄) and their tendency to gaslight at patients’ expense. I am a solicitor - we train for a long time and have to fund our exams too! - and my first reaction to negligence or even poor practice in law is to condemn it, because I value the integrity and skills of my profession and would rather the clowns were removed.

GP’s do the opposite: maybe part of the reason why they are held in such low esteem now. Not every dissatisfied patient (and we are legion) can be wrong.