General practitioners abandoning Britain’s National Health Service

By Ben Trent
19 December 2018

The Royal College of General Practitioners (RCGP) says that one in three GPs will likely quit their practice within five years.

This confirms previous findings that a haemorrhaging of family doctors from the UK’s National Health Service (NHS) is underway, as tens of thousands of people seeking treatment and medical advice already struggle to get appointments nationwide. Many are forced to go to hospital Accident and Emergency departments that are at breaking point.

The RCGP surveyed over 1,000 GPs, with 31 percent of respondents stating they were likely to leave the general practice workforce within five years. Stress was one of the main reasons cited. Out of those surveyed, 37 percent said that there were vacancies needing filling in their current practice. Even more concerning were the 5 percent who stated their belief that their practice would close within the next year.

Another survey released by the General Medical Council (GMC) regulating body concluded there was a high risk of doctors leaving the profession “in unprecedented numbers.” Its poll of 2,600 doctors found that more than half (56 percent) were looking into other career options, with a quarter having already cut their hours or gone part-time. Of concern, noted the GMC, was that the poll revealed that 21 percent of 45- to 54-year-olds and two-thirds of 55- to 64-year-olds planned to take early retirement by 2021. These figures could escalate, with the GMC warning that its findings come amid a backdrop of uncertainty over Brexit, which could affect the 9 percent of UK licensed doctors who are European Economic Area (EEA) qualified.

This corroborates earlier findings, from the national GP work-life survey conducted at the end of 2017, which included 2,195 GPs in England. It found that 39 percent of respondents expected to leave “direct patient care” by 2022. This was comparable to 19.4 percent who expected to leave in 2005 and 35.3 percent in 2015.

The work-life survey found that the principal reasons for stress included: increasing workloads, having too little time to do justice to the job, paperwork, changes to meet requirements of external bodies, and increasing demands from patients.

In September, it was revealed that over 1,200 GPs were receiving support from a specially created mental health service that had been set up to assist primary care doctors. The main reasons were stress, fatigue and addiction-related issues.

The Independent reported that the data suggested that as many as 357 surgeries were at risk of closing due to the direct risks of departing GPs. Given the average number of patients on the books of each surgery, this could result in a staggering 3 million people losing their doctors.

A Freedom of Information investigation conducted by the Pulse GP news website revealed that 1.3 million patients have seen their surgery closed as a result of practice closures or mergers over the last five years. Nearly 450 GP surgeries were closed during that period.

The past two years have seen an unprecedented acceleration of this process. Last year alone, there were 134 GP surgery closures displacing more than 450,000 patients.

Doctor Helen Stokes-Lampard, chief of the RCGP, warned, “We are talking about highly-trained, highly-skilled doctors, that the NHS is at risk of losing—some will retire, which is to be expected, but many are planning to leave earlier than they otherwise would have done because of stress and the intense pressures they face on a day-to-day basis, whilst simply trying to do their best for their patients.”

The crisis of departing health sector workers comes despite the pledge by the Conservative government, made as far back as 2015, to increase the number of GPs by 5,000. Official figures released this May instead show that the number of GPs in England has dropped by a 1,000 since 2015. Vacancies across the NHS, at the end of June, stood at a staggering 107,743 health sector workers .

While data suggests that up to 320 GPs were retained through the GP retention scheme—designed to support GPs who would otherwise have left general practice—the figures are very small and inconsequential comparative to the numbers of GPs leaving. Statistics made available by NHS Digital for 2016/17 show that 5,159 GPs left the profession, equating to 430 departures a month.

Pointing to the historic implications, Dr. Richard Vautrey, chair of the British Medical Association’s (BMA) General Practitioners Committee of England, said, “For the last 70 years general practice has been the foundation on which the NHS is built, but without proper support, investment and a plan to tackle the current retention crisis, it is in serious risks of crumbling.”

In March, a BMA survey found that 54 percent of respondents reported that retention rates had worsened or significantly worsened, with only 7.5 percent reporting any improvement in retention rates.

Last year, Nursing and Midwifery Council (NMC) reported that more nurses and midwives left the register than joined, reversing the year-on-year increase of registrants from 2013 to 2016. The number of registered nurses and midwives dropped by more than 5,000 last year alone, with England having more than 40,000 nursing vacancies.

As with GPs, terrible conditions, as the result of cost-cutting, and the decimation of frontline services have forced nurses and midwives to leave the register. The NMC conducted a survey between June 2016 and May 2017. Of the 4,544 responses received by the NMC from nurses and midwives regarding the reasons for them leaving the register, less than half cited retirement.

In contrast:

* 44 percent cited poor working conditions, for example, low staffing levels and workload.

* 28 percent cited a change in personal circumstances, such as ill-health and childcare responsibilities.

* 27 percent cited disillusionment with the quality of care provided to patients, along with poor pay and benefits .

GP surgery closures and problems in recruitment and retention of family doctors, nurses and midwives are a direct outcome of the starving of funds and policies aimed at accelerating the privatization of the NHS carried out by successive Labour and Conservative governments.

Private GP surgeries have sprung up across the country, in some cases within the same premises of NHS-run surgeries. Those who have money can pay £80 and £140 respectively for 20- and 40-minute consultations and to jump the queues. They can even have full health checkups by paying £450. In contrast, tens of thousands of working-class people continue to wait up to four weeks to get an appointment to see their family doctor in a flying consultation.

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