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?

The service is significantly better @sleepyrant. Easy to access, at convenient times, staff are pleasant and listen and provide solutions plus diagnostics if necessary.

Re GP services, yes I suppose you are right as one can't insure for GP visits/A&E, just as one can't insure to educate one's children.

We opted out of state education; just as we have largely opted out of the NHS. I would support a system of tax relief yes, if I contract not to use public services.

Veterinary care is private. Veterinary practices tend to be well run. I believe it's because money changes hands. The same as my dentist and optician. My dentist does some NHS but it is carried out by Associates/newly quals and supervised.

I don't regard being addressed formally as representing a better service. I regard it as an equality issue and a matter of basic courtesy. If a GP assumes they may use my first name, I expect them to invite me to use theirs. If they wish to be addressed formally they may address me accordingly. That has nothing to do with service and everything to do with basic good manners. My GP may not address me as their subordinate, my accountant and solicitor don't. In 2022 I don't know who a great many Dr's think they are?

You don't understand. This isn't about paying tax on pension over the lifetime allowance - GPs are in the same boat as everyone else on this.

This is about the fact that every year NHS pensions come up with a random figure for the growth of each doctor's pension pot. It bears no relation to what we have actually paid in, and lots of relation to what inflation is. The doctor is taxed on that made-up figure.

So, for example, a friend of mine earns £110k as a senior hospital consultant. According to NHS pensions, last year she put £75k into her pension. Of course she didn't - that would be ridiculous. But as you can't put more than £40k into your pension tax free, she now has a tax bill of 40% x £35k, so £14,000, which has to be paid out of already taxed income. This is on top of her usual tax and NI. Unsurprisingly, she's put in an application to work part time. She doesn't want to work part time, but any extra costs her too much. Hunt tweeted back in May that he wanted to sort this anomaly but he seems to have forgotten now he has his hands on the purse strings......

It's the speculative value of the fund required to pay the final salary pension.

Ask the Tories, those people, that for some unknown reason, keep getting voted back in.

Go to an A&E department at 7am on a Tuesday and there will be people on beds in corridors. I know first hand how bad the problem is.

The system isn't just broken it's completely and utterly fucked!

Also have private medical as I work for a private medical insurer (feel like a traitor sometimes as I'm a labour voter through and through and passionately don't want the NHS privatised) but there are times where a private GP consult won't work, with children with high temperatures and non specific symptoms there is a caveat that you can't use the service for this as they need to be seen by someone in person. And there are no private A&Es in the country (maybe 1 or 2) so even the most insured person will still need to rely on the NHS in certain situations, it has a few gaps that it just can't cover. They are great though for getting a private referral as sometimes with the local NHS GP it's like pulling teeth. I don't think the general public would ever be happy to pay a small fee in this country to see a GP although it seems to work in other countries that have more hybrid healthcare systems.

I would support a system of tax relief yes, if I contract not to use public services.

So how would services be paid for those who do not choose or do not have a choice to opt out of public services?

The service is significantly better @sleepyrant. Easy to access, at convenient times, staff are pleasant and listen and provide solutions plus diagnostics if necessary.

This is interesting. My DH had cause to seek private health care from a consultant earlier this year due to an excessive NHS wait time. I didn't find the private hospital any better in terms of ease of access or organisation. In fact that appointment was 30 mins late too. I guess that will depend person to person. Like wise I have a child who needed access to mental health services unfortunately, CAMHS is a disaster and not fit for purpose but there simply are not private alternatives available either.

When we have needed to use the NHS GP service I have found it efficient. We phone, get a call back then the doctor assesses by phone whether there is need for a face to face appointment, if there is then you are seen the same day. I was given an appointment time. Arrived at the surgery at the allocated time and was seen within 5 minutes of that time. I can't remember whether I was addressed by my first name, I probably was.

I think you are making assumptions of all GPs based on your personal experience.

My sister is a GP. She works really hard so perhaps I see this from a different view point to you. She is not here to give you a 'good service' though she is here to ensure your health care needs are met.

NHS employer contribution to pension is around 20%. There’s not many employers who can do that. There are very few people who have paid so much in their pension that it’s maxed out and tax has to be paid on contributions.
It sounds like a good deal to me. My job requires a professional degree and my employer pays the legal minimum of 3%
Also for those complaining about the tax . Of course you’re not paying twice. You’ve just lost the tax relief of the contribution.

Someone mentioned a scandi system- sounds great but are all members of the public willing to may the huge tax increase it would require.

I think copayment has to be considered to cover all these costs because it’s not logical to take benefits away otherwise more people will leave.

LondonLovie how do you think Labour will fix it? If you mean extra funding who is paying?

Or other way?

Good luck finding a private A&E in that case.

@TightPants there is one at our local BMI hospital - ICU as well. Expensive but no queue.

Hopefully they will increase as people look for timely alternatives.

Yes sure he's a doctor, if he is then he's part of the reason the profession as a whole is so lowly regarded, ew

Ah, you’ve got me. He’s not a doctor at all, and anyone who thinks GP’s are paid a decent salary or otherwise disagrees with your righteousness is either a Tory party shill or a Russian boy. Actually, fuck it - I’m both.

In other words, ODFOD.

Oh and DH’s pension is currently worth just shy of 60k pa when he retires at 65 for life. Anyone else see a problem with paying every retired doctor in that scheme twice the UK’s average salary funded by tax take? If not, I’ve got a timeshare to sell you… 🙄

@BHMiseverymonth I don't think there is- but there should be a 10 year one , same I think for dentists . I also think they shouldn't have student fees and also get grants to balance that up - same with nursing, police etc

And the point you were trying to make @TightPants? The sooner one can access A&E privately, the better. I think The Cromwell has an A&E Service. Current standards in A&E are wholly unacceptable in clinical terms, and civilised terms notwithstanding the wait.

When I was a little girl in the early 60s, the local family Dr had no receptionist, no nurse and people just queued. If a referral was needed he wrote a letter to a specialist with his fountain pen, gave it to the patient and told them to hand it to the Dr when they attended their appointment that they would be sent in the post. The family Dr also stitched the occasional split head and cut knee too. It was simpler but seemed to work better and there was none of this ridiculous first name business. I cannot imagine our old family Dr calling one of the farm workers John or Fred. It would always have been Mr Smith or Mr Brown. Respect begets respect and it's a profession that appears to have forgotten it.

What absolute bollocks are you talking. Patients lived less with FAR less complex needs. Medications were a fraction of what exists now. And all chronic diseases and everything else was managed in sec care. Please do not talk shit about something you know nothing about.

I trained abroad. As did many of my colleagues. Will you reimburse me/my home country then? Because I've never had anything from the tax payer and am a massive net payer.

He will be on the old school pension. It doesn't exist anymore. Apart from the fact we play massively into our pensions. GPs pay both employer and employee contributions for themselves. I pay 1/3 of my income into my pension which I can't take till I'm 67 and won't be like your husbands. The juniors after me are even worse off.
I will have to live to 97 to even break even what I've paid in.
The amount of daily mail rhetoric on here is staggering. And you can tell the spouses of old school consultants who have no respect for GPs. And have pulled the drawbridge up behind them.

Not GPs actually l. GP partners pay both the employer and employee contributions themselves.

DH is (was) a GP. He qualified 18 years ago but left the NHS in April due to a list of reasons as long as your arm. He now works couple days a week teaching med students and advising businesses about staff health. Far less stressful, better paid, better holidays, better pension, less abuse. The majority of his GP colleague are working on their exit plan.

I don't know if this still happens but 10 years ago I had a lovely GP who'd lived in SA but come home to care for aged parents. Referrals to consultants were rationed by the health board and surgeries penalised if they over did it.

Consultants would see patients decide the most urgent cases make their surgical lists. Which would then be altered by the management. This was frustrating for surgeon and patient but in Wales surgery isn't consultant led.

And you wonder why med students decide to go overseas when they get years to observe all this

I mean thats all rubbish but ok

You mean he wasn't ecstatic at pushing papers from 9 to 5 for 200k and a gold plated pension? Shame on him

@memorial I know very well how life in the Home Counties operated in the 1960s thank you, I was there. Times may have changed and I accept that, but things were done far more swiftly without bureaucracy in triplicate and in those days GPs actually got their hands dirty.

I am quite sure our old family doctor back then would have had the background and education to argue a point eloquently without resorting to words like bollocks and shit whilst entirely missing the point.

Times and your profession have certainly not changed for the better. It's actually very sad. It's actually why the system has to change and return to a time when GPs deserved respect.

I worked in a role linked to medical training around 20 years ago. There were a huge number of warnings then that we were heading towards a GP crisis. With many more GPs opting to work family friendly part time hours and it being the first specialty to achieve equality of the sexes (apparently), it meant they would have to increase the number of training post available to keep up. For every 1,000 GPs being trained then, it was predicted they would need to train 3,000 to take in to account part time working, those moving to private practice only and net migration. The number of training posts were never increased in line with the schedule the experts recommended.