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?

GPs are overworked and retiring early. Younger ones are emigrating to better pay and better working conditions in Australia, NZ and the US. The Tories have failed to plan for more medical school places for students. Those who voted for Brexit now see far fewer EU doctors coming to work in the UK (and that includes heart surgeons to work in the NHS - see today's Guardian front page): the visa and paperwork needed are a real obstacle. Why on earth Starmer thinks we should not have free movement I don't understand unless he's terrified of the working class Brexiteer voters.

GPs are overworked and retiring early. Younger ones are emigrating to better pay and better working conditions in Australia, NZ and the US. The Tories have failed to plan for more medical school places for students. Those who voted for Brexit now see far fewer EU doctors coming to work in the UK (and that includes heart surgeons to work in the NHS - see today's Guardian front page): the visa and paperwork needed are a real obstacle. Why on earth Starmer thinks we should not have free movement I don't understand unless he's terrified of the working class Brexiteer voters.

Roselemon Net migration of over 500k in 2022 adding to the population with fewer people entering the profession? Aging population?

Those GP's have probably worked more hours by the time they retired than your Dad will have done by the time he retires. And all those extra hours are unpaid in medicine, not the cushty overtime in engineering

In the interests of accuracy, most private sector jobs over a certain salary or grade pay zero overtime. I’ve never been paid overtime as a solicitor.

I’m married to a doctor btw.

Why on earth Starmer thinks we should not have free movement I don't understand unless he's terrified of the working class Brexiteer voters

He is, which clears that up.

• Population is older and heavier so more pathology
• Decline of the nuclear family - so many things I get asked that grandma would have sorted in the past
• Better management of risk factors so people don't die early of strokes and heart attacks, but get old and develop complex frailty and dementia. Ditto better surgery etc keeping elderly folk alive
• The realisation that 5-10% of the population have some sort of neurodiversity for which they want referral
• Inability of the younger generation to understand that most coughs, colds and sore throats will get better by themselves
• The world and its wife thinking that you should 'get a letter from your GP to say that you are fit to......' to absolve themselves of any legal responsibility

That's off the top of my head. I'm sure I can come up with more

I would never want me children to have to care for me in my old age, absolutely not! I want them to have there own lives, the world is a wonderful place, they shouldn't for a second feel tied to the UK just because that's where they were born. They're all very bright 9s and A* exam results and predicted. They also know they can't just rock up with no skills or experience and get a job somewhere, those days are gone. They know they need to get themselves as highly skilled as possible to get visas to live/work in other places. Good luck to them I say. And people in the UK have absolutely no right to complain about young doctors taking their training and moving abroad, not while we are recruiting overseas medics in such huge numbers ourselves.

Actually, I agree, they should. Likewise when other countries pay to train medical staff, then they move here.

You’re right we do have people coming in. Which seems to go against idea of dire outflow. We get our own supply.

Obviously people move all the time but given the repeat negativity from some I’m not surprised re posts and dc leaving asap

Plus use visas - which I’m sure do exist already

And as for lots of young people from the UK leaving, we can just increase immigration from countries with a bottom heavy population and not enough work available for their young people.

I fully agree. I'm an accountant and worked most of the last weekend trying to save a client's business and avoid them having to lay off their workforce, by working on forecasts/projections to support loan/overdraft applications.

In January, before the self assessment deadlines, I'll be working evenings and weekends on top of full time during the day.

I'll also be working on New Years Eve attending a client's stock take.

Yes, none of this is life threatening, but still needs to be done. I think all professions have elements of evening/weekend and unpaid working. To think accountants and solicitors never work evenings and weekends is pretty naive really.

😂😂You've clearly never supervised a nurse practitioner. The idea that a hospital would want to see everything which is beyond the skill set of an NP is very sweet and naive but has no bearing on reality.

Aus has own issues and France link below. It’s a growing problem not just here

"The shortage of GPs in Australia is a serious issue that is already affecting the entire health system and will continue into the future if this issue is not properly addressed," Senator Ruston told AAP.

healthtimes.com.au/hub/public-health/50/news/aap/australia-facing-decadelong-gp-shortage/7412/

Because the vast majority of queries that I get from my NP I can sort in the community and don't need a hospital visit.

I certainly think there's merit in the type of "clinic" that we see in some European countries, where it's a kind of "one stop shop" for all the minor things, like small strains/breaks, basic x-rays, cuts and bruise dressing, prescriptions for the common ailments (antibiotics for infections and medicines/drugs for sickness/vomiting bugs, etc). You get seen by a nurse and then "triaged" to see a doctor if necessary.

Of course, a lot of that used to be done within GP surgeries and small/cottage hospitals (in fact many rural GP surgeries used to have small wards).

We do seem to have gone too far towards centralisation and huge central hospitals and left a pretty big void in local/small scale provision.

Training a doctor costs up to £300,000 of public money. Training them up just so that they can go and work abroad at the earliest opportunity has to be a bad thing. My suggestion would be that, taxpayers having invested £300,000 in their education, they need to guarantee to work in the NHS for 10 years at least before they can take the skills we gave them elsewhere.

France has a similar shortage of doctors:
www.politico.eu/article/france-doctors-europe-too-far-too-old-too-few/

Apparently doctors here in the UK are paid rather more than many in Europe.

Seems like healthcare is turning into a clusterfu(k☹️
and not just in the UK

At some point we are going to have to start paying something to see a GP.
Everyone wants more money put into the NHS but no one wants to pay the higher taxes to fund it. The money has to come from somewhere.

Wales do similar for some HCPs- if they get a degree there their fees are paid but they have to work in Wales for 2 years or pay them back (this doesn't apply to doctors but nurses etc but similar idea of a return of service). Seems fair, I'm sure most students in England would be delighted to not have to pay fees seen as though they do full time placements and are often utilised as an extra pair of hands due to shortages.

I'm curious where the £300k figure for doctors comes from though seen as though they pay uni fees, don't get paid for placements, have to pay for lots of their own training and portfolio stuff etc- and their pay as an F1 is insultingly low. Trusts do get paid to host students but 300k per student is stretching it in terms if the cost to the taxpayer.

How many people are shit scared of becoming ill these days? ☹️

Thankfully, we are pretty healthy and can afford private if necessary but the vast majority of those who need the service most cannot nor should not have to try and find the funds to pay for what should be freely available.

The NHS has virtually collapsed!