All the doctors I know are leaving. Are we going to be screwed for healthcare in 5 years time ?

[Gigihadr]

Our NHS now has some of the worst health outcomes out of 19 wealthy nations compared in an international study.
But in 2010 the NHS regularly ranked 1st or 2nd in most international studies.

The UK is under-doctored, we have a 3rd fewer doctors per 1000 people than Germany or Spain

Our government response to the doctors we have left has been to erode working conditions and pay, ensure they have record levels of inflation and rocketing student debt

They are moving to better paid, better resourced systems/employers (they are a competitive international commodity) and I can’t blame them for that.

AIBU to think we are utterly screwed? why are we just sitting back and watching this slow motion car crash ?

That’s right blame the people who have paid tax all their lives for the screw up now happening!

But they haven't all 'paid all their lives'. My frail elderly MIL with a multitude of health problems gave up work at 25 to raise two DC and has never worked a day in her life again. Like many women of her generation.
It's not blame, it's just a fact.
They're now starting a six month course of chemo on my frail 80 something FIL with two forms of aggressive cancer.
As long as we try and push everyone to live until they're 110 this issue will persist.

The BT engineer who came today used to be a healthcare assistant, and worked throughout the Covid pandemic. I asked if the horror of that had made her leave to be an engineer and while she agreed it probably sped things up, she’d have left sooner or later anyway, because of all the constant stress.

I retired early because of the stress and toll it took on my mental and physical health, and that was in 2016, so goodness knows how much worse things are now. And of course the more people leave, the fewer there to fill all the vacancies/do all the work, it has a knock-on effect.

Both the former HCA and I feel terrible guilt at having made things harder for our former colleagues in the NHS. It’s not just doctors who are leaving in disgust and despair.

You get what you pay for, and the NHS has been financially starved for 13 years. It’s hard to care for other people when your own employers care so little for you.

I also second the commenters here talking about doctor ‘alternatives’ becoming the norm in the UK. It is the ultimate plan of the government to replace doctors with cheaper alternatives who haven’t been to medical school or had the training doctors have had. They will be marketed as ‘highly trained clinicians’, but aren’t doctors and dont have the same depth of training or experience. In reality, this means if you go to the GP or hospital you won’t see a doctor - you will see a nurse practitioner, physician associate, paramedic - hence reducing the number of doctors they need to train and employ. It will be healthcare on the cheap, as all the government cares about is quantity not quality. This is the model being used in USA - and it’s telling that they have worse health outcomes than we do. This could be avoided by paying doctors properly to stem the workforce crisis and training more UK doctors to become consultants. If you find the situation facing us scary or unacceptable - NOW is the time to do something about it!

I hope you aren’t a doctor as you have been pretty disrespectful of other health care professionals here. There is nothing wrong with nurses, pharmacists, paramedics etc wanting to advance their practice and yes this will mean a blurring of roles and boundaries. That isn’t necessarily a bad thing. Junior drs issues with their pay have not been caused by those working in advanced practice.

Plenty of these ‘pseudo doctors’ can prescribe though, can’t they? Certainly plenty of nurses and pharmacists are independent prescribers. I don’t see a problem with this except they’re not that much cheaper than doctors so I doubt they’re going to sort out the NHS’s cost base.

It’s a bit like when we had (still have? IDK) a shortage of HGV drivers, and the government just reduced the training and some of the skills required for the test, like reversing (or something equally necessary and difficult to do).

Quick fixes, sod industry norms. It’s what Brexit was for - cut corners, do everything on the cheap. It’s all very Oceangate.

(Will the Oceangate tragedy become known as Oceangategate, I wonder?)

Cross post. I also see nothing wrong with these professionals furthering their qualifications and expanding their remit. It really doesn’t bother me if I am seen by a nurse or a GP provided it’s a qualified professional who is able to prescribe what I need.

Often the GP is a locum who gives zero fucks, so it’s often preferable to get a nurse or pharmacist!

It’s not other healthcare professionals who are devaluing doctors, it’s doctors themselves, chasing money through locum work instead of committing to a practice and giving a shit about their patients and community.

As I said before I’ve worked with some brilliant ACPs/ANPs and learnt lots from them. But on the whole they have less training and less responsibility than a registrar

I’m assuming you’re a Paeds ANP if intubating etc? I may be making an assumption here! I don’t know which specialty you’re in.

I think this issue is that as an 8a ANP you’re paid more per hour than an ST8 registrar who carries more responsibility and has undergone more rigorous training (including royal college membership exams), rotated round a region gaining subspec experience etc. I don’t think ANPs are overpaid I just think that doctors are underpaid. And ANPs have much better working conditions than doctors and as they’re not rotational are usually treated better by other permanent staff in my experience.

You don’t have huge tuition fee loans that you’ll never pay off due to interest. You were paid well to do your masters whilst doctors paid for their own professional exams and study in their own time. We just feel we’ve had a raw deal.

If there’s an emergency and there’s an ANP and an ST6 there it’s the ST6 leading it in almost all cases and it’s them who carries the most responsibility for the case, who’s had more training yet is being paid less than the ANP. Becoming the ANP was the smart move! Medicine is for fools now. And it is pretty terrifying how many doctors are jumping ship.

@DataNotLore it's literally in the opening post: Our NHS now has some of the worst health outcomes out of 19 wealthy nations compared in an international study. The system is actively killing us at this point.

I said it in my previous comment but I’ll reply again here: you have every right to be pissed off with your working conditions and pay (I’m pissed off on your behalf and wholeheartedly support any industrial action doctors plan to take!)

However, your poor working conditions and pay are an issue all their own and can’t really be compared to what other HCPs are being paid because they are different jobs with different pay scales. Apples and oranges. Get angry about your own pay by all means (and I don’t know anyone who wouldn’t fully support you) but do it without making someone else’s pay the problem.

It would be interesting to see how the "ageing" part of the population voted over the last couple of decades.

They can prescribe. And they can order X-rays as far as I’m aware.

I saw one in a&e when I broke my foot and she certainly seemed to do everything. Guess maybe she asked a dr for some of it?

OP you are spot on in your opening post.

UK is rapidly becoming a 3rd world country with an enormous brain drain

@Medstudent12 and other medics on thread your crappy pay and working conditions don’t entitle you to belittle the skills and contribution of others.

As a nurse I support your campaign for better pay and conditions but really disappointed in your attitude to non doctors.

It was working back in 2010. I wonder what happened that it's in such a state now.🤔
https://www.google.co.uk/amp/s/www.bbc.co.uk/news/10375877.amp

Legally she cannot prescribe or order imaging. She would've had to discuss your case with a proper doctor and take their management advice. She should have been honest with you that a doctor was providing your care behind the scenes, rather than misleading you.

You do realise that the strategy is to do nothing, so as to erode and cripple the NHS so that paying for health insurance is the only way to get treatment. Hence the Health Secretary is fine with the strikes and will not budge. Doctors junior and senior will keep striking because further erosion is no longer tolerable and leave the NHS as soon as possible. The better ones will leave first and those left will justify calls to break up the service due to it degrading past saving.

If they want to "advance their practice" beyond the profession they've chosen, they should go to medical school.

I have no problem with nurses, pharmacists, physios etc. that work within the scope of the degree they hold.

I take issue with those who've decided to advance their own interests and salary by demanding the right to play doctor without going to medical school.

Medical school isn’t a requirement for advanced practice.

Why? I don't think anyone has aside from those in roles that are undefined, unfit for purpose and that are dangerous for patients and undermine the role of a doctor. If HCAs started to get higher pay than you even though you still took on the ultimate responsibility would you be chill about it? A PA for example is less qualified and has less actual responsibility than a doctor but gets more money and better working conditions; how does that make sense? What if your training opportunities as a nurse were taken up them meaning you were left with less chance of progressing in your chosen field? ANPs are great but they should be regulated to ensure people aren't using the title that shouldn't and to prevent scope creep (it's not legally protected).

It should be. That's the point.

If you are a doctor then I sincerely hope you’re either retired or nearing retirement because your contempt for HCPs you feel are somehow inferior to you is absolutely vile.

ANPs/ACPs do work within the scope of the degree they hold and the years of additional training they’ve had.

No one is inferring anyone is inferior to anyone else as an individual, but of course in a healthcare setting doctors are top of the hierarchy- that's no offensive to say.

@SisterDonnarix has absolutely inferred that, which is why I quoted that poster in my reply.