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HARDLY a day goes by without GPs featuring in the headlines – and usually not in a positive light. Recent surveys on GP workload and access showed positive results – family doctors spending 40 per cent longer on each patient consultation and an 86 per cent satisfaction rating – but it became another excuse for rolling out the argument that GPs are “working less for more money”.
I am concerned that GPs seem to have become the whipping boys for everything that is found to be wrong with the NHS. This obsession with GP pay is wearing thin. It is exaggerated, unfair – and must be brought to an end.
Hardworking GPs in their practices will not come out to defend themselves – and why should they? So I will say it for them: doctors deserve their income.
The reality is that GPs are seeing more patients, providing more services and dealing with increasingly complex clinical problems. They are making a real difference to the lives of many patients and doing much more work to prevent fatal diseases, as demonstrated by reduced deaths from cancer and heart disease. On every working day 800,000 people will see their GP and 1.5 million prescriptions will be issued. If we did not have GPs, more patients would end up in hospital unnecessarily.
So why is there so much negativity about GP income? This income is a combination of many factors, including the achievement of demanding clinical targets – and is comparable with that of many professional groups.
Aside from the 10 years that we spend training and qualifying, we need to keep abreast and remain one step ahead of latest developments in the ever-changing world of medicine. Every diagnosis and decision we make is potentially life-changing for the individual patient and the potential impact of a mistake immense. How many other professions operate in such a high-risk or fast-moving environment?
Of course there are improvements to be made. GPs are not complacent and are keen to develop services more. The issue of appointments worries GPs as much as it does patients. Access to out-of-hours services is a legitimate concern and Primary Care Trusts – whose responsibility it is to organise care – need to make significant progress in improving standards.
Patients want quality care from GP teams whom they know and who know them and we want to do more to improve the care that we deliver to patients – but it does not help if all we get is GP bashing.
GP services are the best-in-class in the NHS family and they should be recognised as such. Instead of attacking Britain’s hardworking GPs, we should be asking searching questions about the extraordinary amounts of money that have been spent on endless NHS reorganisations in recent years – and the £500 million cost of external management consultants.
It is time to get beyond the headlines of “less work, more pay GPs” and concentrate on how we can work together to tackle the very real issues that concern patients. GPs are the glue that holds the NHS together. They are part of the solution to lasting improvements in the NHS, not the problem.
Professor Mayur Lakhani is chairman of the Royal College of General Practitioners
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Are we Miners?
Let's suppose that the government continue to make conditions so bad for GP's that eventually we are balloted and surprise ourselves by resigning.... quick as a flash Tesburyoots will agree to take on our contract of care , and run a service on £40/hr Doctors , paramedics and nurses .
It could happen.
Lots of Drs pouring out of UEA and allied Medical schools , all potentially unemployed, and accepting employment at £35/hr.
We have to impress upon Ourselves first , then Patients, Politicians next that we currently offer an extremely Professional , effective , safe and remarkably economical service.
We are extremely good at doing what we do. No-one else , no algorythm, few if any nurses and certainly no paramedics can offer our level of forensic consultation and problem solving skills.
Believe in our own excellence , and others may follow. Accept constant harrassment and " evil triumphs when good men stay silent " (or something like that )
jrbell, harpenden, uk
The issue of extended hours and the bedfellows of HMG and CBI is interesting. The CBI bemoan the fact that their "workers", who "make" the profits for the companies, need time off to see their GP because they cannot see them in their own time and that GP's need to wake up to the 21 century.
Well tell me this Mr CBI and Ms HMG - if your companies were told that any money or profits they made between 6.30pm and 8am could not be kept, do you really and honestly think Tesco etc would stay open? They are open because every person through the door is going to add to their profits. They have to shelf stack at night, so why not let the punters in and boost the takings.
Keeping GP practices open 24/7 would not do likewise.
But wait, maybe if we opened longer hours we would achieve better results for Government targets then boost our income again ............ but that wouldn't do either would it? GP's are an easy scapegoat for HMG who DIDN'T listen in 2003/4 and are now paying for it!
Dr David Jones, Bangor, Gwynedd
It's all very well for Wanless to say that the nation has not reaped the benefits of increased pay for clinicians. What he forgets is the iniquity low pay and rediculous hours that existed before 2001.
As for out of hours, it shows that the government and its aparatchiks cannot be trusted to provide what doctors did before. I cannot envisage a return to 24 hour GP cover as was the case before.
It is interesting that NHS employers now want to peg GP in come the the reduction of obesity - that's rather like paying King Cnute by level he can reduce sea level.
Is it time for doctors to abandon the GMC and take back regulation? I advocate leaving the GMC en-masse.
Manas Sikdar, Hove, East Sussex
Thnks to Prof Lakhani fromsomeone on the shop floor of UK NHS primary care general practice
Dr Mark Nettleton, Lowestoft,
I can't agree more with Prof Lakhani.
DR.S.GADA, COVENTRY,
Prof Lakhani is absolutely right to defend the role of General Practitioners and Government is wise to invest in Primary care.
The benefits to patients' health more than justify extra investment in primary care.
The evidence is clear that countries whose health systems are more oriented to primary care achieve better levels of health, higher life expectancy, better health outcomes, higher satisfaction with health care among their populations, lower overall healthcare costs and lower medication use. Delivering top-quality patient care under the new GP contract is saving thousands of patients each year from having a stroke, heart attack, or other serious health problems. We keep patients out of hospital and save the NHS millions.
GPs certainly now earn more than they did, and quite rightly so. We spend at least nine years training before we can even start in general practice. Not many other professions take that long before they can start to work independently and earn "reasonable
kailash Chand, Ashton-U-Lyne, UK
hurrah! thanks to mayur lakhani - someone has finally stood up for GPs and the work that we do...there is nothing more demoralising then trying your best with what services there are, and then getting blamed when things go wrong...it must be easy for people who have no real responsibility (beyond selling papers and making profits) to point fingers and accuse - i hope the press move on from GP and NHS bashing and show us and the NHS in a more positive light
amee bhatt, london,
Quite right Mayur!
Dr Mary Church, Glasgow,
Prof Lakhani is absolutely right to defend the role of General Practitioners and Government is wise to invest in Primary care.
The benefits to patients' health more than justify extra investment in primary care.
The evidence is clear that countries whose health systems are more oriented to primary care achieve better levels of health, higher life expectancy, better health outcomes, higher satisfaction with health care among their populations, lower overall healthcare costs and lower medication use. Delivering top-quality patient care under the new GP contract is saving thousands of patients each year from having a stroke, heart attack, or other serious health problems. We keep patients out of hospital and save the NHS millions.
GPs certainly now earn more than they did, and quite rightly so. We spend at least nine years training before we can even start in general practice. Not many other professions take that long before they can start to work independently and earn "reasonable
kailash Chand, Ashton-U-Lyne, UK
Well said Professor Lakhani.
He describes the realities of GP work, workload and responsibility well. GPs do want to provide a good service to patients. At present we achieve this despite an NHS that tries to hinder us at every turn.
Dr Peter Davies, Halifax, West Yorkshire
Prof Lakhani is absolutely right to defend the role of General Practitioners and Government is wise to invest in Primary care.
The benefits to patients' health more than justify extra investment in primary care.
The evidence is clear that countries whose health systems are more oriented to primary care achieve better levels of health, higher life expectancy, better health outcomes, higher satisfaction with health care among their populations, lower overall healthcare costs and lower medication use. Delivering top-quality patient care under the new GP contract is saving thousands of patients each year from having a stroke, heart attack, or other serious health problems. We keep patients out of hospital and save the NHS millions.
GPs certainly now earn more than they did, and quite rightly so. We spend at least nine years training before we can even start in general practice. Not many other professions take that long before they can start to work independently and earn "reasonable
kailash Chand, Ashton-U-Lyne, UK