To wonder why we don't force GPs to work as NHS employees like every other doctor

[OptimismvsRealism]

They're the weak point for the entire health service and they make a fortune while hospital doctors pick up their mess

Force them? YABU!

@Atethehalloweenchocs The practices have to make a profit, the staff are paid out of that profit. But my experience is that GPs don’t do their job solely for the money

The NHS has a reputation for "part time doctors" because the remit of a full time doctor has crept up to the point that you need to be working 80 hrs a week to fulfil all your obligations.
A lot will drop down to 50%fte to get a 40 hour a week workload which is what most other professions would call "full time"

I hope you are right @Susiesue61 - but that has not been my experience over years of working closely with GPs. Not saying all GPs. But a distressing amount of them.

Seems to be the similar think tank of late..
'Look you fucking idiots,do as I tells you, it's better, you're stupid and need to do what you're told, you're not important or your opinions/needs, my views are so much better' ?

I pay my cleaner an hourly rate not much less than a junior doctor.

The salary is good as you progress, but not so much that I think many people would work as hard as doctors do for the money.

Earn twice as much in the financial industry in the City.

@Pinkplatter , I’m not sure @OptimismvsRealism has the first clue.

That was the agreement that Nye Bevan had to make to get the GPs to agree to be part of the NHS.

@OpizpuHeuvHiyo , yes that is true my elder son is a GP and his hours are punishing. His practice has been given 2.5 ish % uplift this year while all expenses are rising way above that and staff wages are up by 10%.

As somebody who has also worked in the Canadian healthcare system - that is pretty rich! A part time NHS GP is generally still working 40-50 hrs a week, seeing 30-40 patients a day. A Canadian GP is seeing about half that number, for twice the pay.

Wonder why NHS GPs migrate to Canada but not many Canadian GPs migrate over here? 🤔

I've heard so many conflicting reports on GPs I've no idea what to think!

@Apolloneuro Yeah definitely not my view. I’ve had a hard time over here this week with people talking about our tiny racist island 😢 and part time doctors. And our shit weather.

And do you guys know what? Canada has MANY problems. I cannot wait to come home.

(PS I also work part time! Canadians don’t have much annual leave - I wonder if they’re bitter!)

i believe billing/funding and liability have changed making it really unattractive to be a gp at the present time. the coding of all complaints the ability to only code so much per visit is problematic and often not a reflection of what the actual appointment visit is like. i believe the amount of people with complex and chronic conditions is more difficult to manage especially when even doctors have difficulty getting the specialists to see people in a timely fashion.
the population is sicker there are less gp's so more pressure with less support by the equally less than required specialists, other health professionals, and available hospital beds.
i think it's a case of shit flows down hill and the gp problem is a reflection of issues higher up.
being a hospital physician is a totally different specialty with different support systems in place to assist in providing care different overheads and a different level of expertise.

Love this “that’s pretty rich”… I’m on holiday so I don’t know the ins and outs of what Canadian doctors do / don’t do but it was definitely said with a smug “we’re better than you” tone

😭

From gpworld:

General practitioners (GPs) in the UK can earn a wide range of salaries, depending on experience, location, and type of GP:
Junior doctors: Earn between £32,398 and £37,303 during their foundation training
Doctors in specialist training: Start at £43,923 and can progress to £63,152
Salaried GPs: Earn between £68,975 and £104,085 in England, £71,738 to £108,249 in Wales, £69,993 to £104,468 in Scotland, and £69,974 to £105,592 in Northern Ireland
GPs in London: Can earn an average of £114,000 per year, but some community GPs can earn up to £150,000
..........
Consultants' basic NHS pay will be between £93,666 and £126,281, with average full-time NHS earnings likely to be around £143,100 once additional earnings are included to cover things such as on-call responsibility, medical awards, geographical allowances and additional activity.
...........

Both seem reasonable to me.

My GP surgery is excellent, everyone works hard and the medical staff are very caring.

@Musicaltheatremum , my elder son is a GP Partner and his working life is pretty tough. No one believes it though…

I’m a GP. I’m near to retirement so I’ve reduced my hours. I now work about 30 hours per week. I trained for 9 years to become a GP, I’ve also got several post-graduate diplomas, and I’ve been a GP for 30 years, so I’m pretty experienced. My practice is in a fairly average medium size town.
OP, tell me how much you think I earn.

Yes because when a GP practice is not run like a business - redundancies happen and practices close. So yes, they have to have business managers to ensure they remain a going concern to enable them to serve their patients

They’re not ‘the weak point’, they’re the lynchpin. Traditionally the money was very good - practices who mismanaged / didn’t focus on productivity still functioned as there was money in the system. There were some (a minority but probably not as small as we’d like) who made a fortune.

Those days are long gone. Practices have to be efficiently run and mop up a huge amount of stuff that many aren’t paid to do through their contracts - nursing, phlebotomy, coordination of secondary care inputs etc. Many have huge mortgages on their properties, which often are not valued at domestic prices. Most GPs work really hard and increasingly do portfolio carers - it’s a brutal job - demanding and rude patients who are suffering from all the wider determinants of health and want everything immediately like Amazon deliver, staff management, business management, hate from the press, increasing pressure to do xyz they’re not paid for appropriately. These people train for years - they are skilled and we will only keep them for a decent wage. It’s all well and good shrinking wages back to what the average person thinks is reasonable. These doctors, who have a tonne of debt from training, will simply up and leave for Australia where they can earn double. We need to be very careful what we wish for.

And no, I’m not a GP / married to one / a family member of one.

I am a GP and I am f—ing exhausted!

• primary health has been underfunded for decades
• the government loves to blame GP for things that are not their responsibility eg inability for me to refer to specialist
• I am not able to practice the way I was taught too.. good luck in seeing a gynaecologist where I work .. they will only see patients with cancer and unless you have cancer you won’t have surgery so if you have heavy bleeding and a haemoglobin of 80 despite iron infusions.. I am sorry, we won’t offer you a hysterectomy, go back to your GP.
• GP’s are leaving in droves and those that stay are not able to work “full time” because you would kill your self.. my “part time”Gp job can be 50 hrs a week
• I can be at my desk at 8 am and still be there at 8pm looking after scripts and paperwork. I have often had 15 mins for lunch. I am struggling to exercise and am utterly exhausted.
• I work in a country with a similar health system to UK but not in UK. At least we have 15minute appointments as standard .. I wouldn’t be able to work with the 10 minute model and take my hat off to UK docs.. their workload is not compatible with good primary care.

There are plenty of managers that work hard, and nurses that don’t and vv.

You won’t solve a thing dealing in cliches like that.

As someone who isn't a doctor, or an avocado, which autocorrect nearly made me (or you), I'd say for 30 hours work a week, as a GP, my thinking would suggest you should be on about £45k a year?

No it doesn’t that’s bullshit.

Health boards hate having to run gp surgeries - it costs them a fortune and the service is far shitter.

Good question! I also wonder why doctors pay is not under the Agenda for Change and is totally separate as are doctors pensions - always wondered that??! I worked in nhs A as an AHP for years and was seconded to HR for the job assessment projects. So many historical inequities within healthcare- largely focusing on doctors hmmm?!!!

I think you're misunderstanding the OP's suggestion.

'Focing them to work for the NHS' is slightly ambigulously phrased, but in this case doesn't mean taking a random selection of doctors and forcing them to be GPs. It means changing the employment status of existing GPs from contractor to direct NHS employee.

From a clinical point of view the job would be much the same - and they would be entirely free to do the job or not - but with a different funding arrangement so the GPs would not be running their own business.