Has General Practice in England reached a tipping point?
During the last eight years, since the negotiations that led to the new GP Contract of 2004, there has been an increase in the workload and an increase in the complexity of the work of GPs and their staff. Work as moved out of hospitals and is now done in the community and in the surgery. Most doctors work long hours into the evening after seeing patients doing their paperwork. They are checking repeat prescriptions, writing referral letters, checking the results of investigations and consultant letters. The quality of their lives and that of their families is suffering. Many doctors already work only 4 days a week and other for less. This is the only way they can survive.
More recently the NHS reforms and the Health and Social Care Act has further increased the workload by making them take on the task of commissioning healthcare as part of the Clinical Commissioning Groups.
The Government has changed the pension arrangements for many public sector workers including doctors and nurses. This has meant increased contributions and reduced pensions.
Within the last few weeks the Government has proposed to change up to 30% of the GP contract by next April. If this proposal is not accepted they will impose it. They are offering1.5% extra to practice resources knowing that 61% of all gross income is currently used to pay expenses such as staff costs. They acknowledge that GPs are looking after an extra 3.7 million people for no extra funding. In addition they are asking for an extra 4% work for no extra funding. The GPs are not impressed!
A considerable number of current GPs are in their 50's and 60's and so near retirement age. It is possible that many of them will jump ship early due to the changes mentioned above. Certainly their families hope they will.
This could mean that surgeries, already stretched to the limit by increasing demand, will not be able to continue to work safely.
Is this the tipping point?
Is General Practice sustainable in its current form?
Will anyone want to become GP?