To think this budget will finish us off

[BurnoutGP]

I am a GP Partner of over 20 years. I am now senior partner for the last few years. We have seen year on year below inflation funding increase. With an explosion in demand and massive shift of work from secondary care. We have issues wirh recruitment.
Our partner income is shrinking year on year. We are now always overdrawn and this gets worse every month.
We just cannot soak up the MLW and NI without adequate resource uplift.
I think we will be done. I'm so very tired of the constant battle and the demand and anger while working "part time" 60hr weeks.
We will have to hand back our contract. And we wont be the only one. That will leave one surviving practice in my area.
I'm done.

Back to where we were 15 years ago? In the deepest recession since the 1930s? Not long at this rate.

You can “imagine” all you like, my brother’s a GP and doesn’t have to imagine that what you’re suggesting isn’t the case. Of course you could find things on the margins of their work that could theoretically be done by others, but the truth is they don’t have time to do all the work that needs to be done as it is.

Seeing extra patients who don't have a free appointment slot mainly, because they have agency and run the business. As well as all the stuff to actually keep the practice going.

So what is all this work that would require so much more time that an extra 50% of a salaried GP would be needed to cover it?

Brilliant! Trying to sneak that into a question, so if I answer it, it’s implied I agreed the Tories made a mess. Quite brilliant but oh-so-fucking-transparent.

The question you should have asked is this:

How long do you think it will take Labour to create an even bigger mess than the one they allege they inherited from the Tories?

Now that I CAN answer: Say 1,825 days (5 years) divided by 120 days (i.e. roughly their current tenure) x the implied value from the following:
a terrible budget (look at the bond market) + inflation busting public sector settlements + resurgent inflation (its coming) + ‘dressgate’ + an inability to ‘smash the gangs’…

I could go on (unlike Labour at this rate).

And supporting other staff, which never has any time allocated

Insurance and other medical reports

Safeguarding

Loads of things

Insurance and other medical reports

GPs charge privately for these, so why should the NHS cover them if the GPs became salaried?

True, but they need a dr and so would need time away from appointments.

Everything you’ve listed - apart from seeing patients without appointments - could be done by staff without medical training. The community healthcare model staffed by salaried GPs would employ support staff on lower salaries for all that, leaving GPs to focus on patient care. The one thing that’s universally agreed is that the NHS needs reform and the GP model is ripe for it because currently it just doesn’t work.

But they would be relieved of practice management responsibilities, IT, payroll, HR, managing premises, accounts…

If salaried GPs wish to undertake private work then they should do so in their own time. Like private consultants.

I like working in a practice because all that stuff generally works. If taken over by 'the NHS' it'll be the same shit show as in hospitals. And you still have the main issue that partners will fit in extra patients, visits, palliative care reviews etc and actually sort patients out when they see them, there would be a lot more working to rule so something that now takes one appt might take 3.

So who do you want to fill in your travel insurance form when you're ill and can't go on holiday?

If seen quite a bit of dialogue about care homes having to close. It’s a complete fuck up.

If this is the case it's the major thing that impacts the NHS

Absolutely nuts

We’ll absolutely- most people working in these places are on minimum wage. Surely the Labour chancellor isn’t that stupid? Surely she would have thought this through? Right??? Right….,????

It wasn’t me that came up with the 50% figure so I’ve no idea how accurate it is.

But GP partners manage their practice and everything that goes with it… premises, HR, etc. If you’re a salaried GP, then you just do GP work.

We could theoretically get rid of the GP partner model altogether and increase the NHS payroll still further, making it even more bloated, but I’m not at all convinced this would make things more efficient and would do anything to ease the GP recruitment crisis.

When we were in that situation our NHS GP charged us £35 to do it and requested the cheque be made out to her personally and not the practice and that was in 2008! And when it wasn't ready when they said it would be, the practice refused to post it because they didn't pay for stamps!

But GP partners manage their practice and everything that goes with it… premises, HR, etc. If you’re a salaried GP, then you just do GP work.

Precisely and that’s exactly why the current model is so wasteful. I don’t want my highly trained, highly paid GP doing all that stuff when patients can’t get appointments. Hopefully this is an area the government’s reform will address because it’s needlessly expensive and hopelessly inefficient now.

You’d think so wouldn’t you, but it seems not. As I wrote earlier, to cover the extra cost of NLW and NI (which is disproportionately high for the care sector), modelling indicates that there would
need to be an extra 6% Council Tax rise ABOVE the amount it needs to rise for everything else. It’s disastrous…

You should see how expensive and bad hospital.management is.......

I have. I worked in hospitals for decades. But it’s not so bad they have surgeons doing HR or A&E consultants dabbling in finance.

It’s a train wreck! I’m perplexed as to how anyone is defending this Budget. It’s so ideologically driven that any actual grasp of economics seems to have been cast aside. It’s seems Labour don’t care about the average person, about this country. There are certain people in both Government and on this thread whose only goal is to punish the rich for being rich and they don’t care who they step on to get there. Labour are not the friend of the average person.

Yes they will just keep blaming the Tories even though the Tories were left with a note saying there’s no money left after the last Labour Government. After this round we will be lucky of there’s any money, jobs, society or country left

Indeed. Social care is in dire need of urgent reform and attention. This budget has made it significantly worse. It’s astounding that it’s not being addressed as the knock on effect is that it directly affects bed space in the nhs as well.

Sadly just throwing more and more money at the NHS without reform will just result in more of the same as before.

No one can say this is a good idea surely?