Anne Marie Waters
Sunday 24th October 2021
General Practitioners (GPs) are primary care doctors who are often the first person a patient sees before being referred on for specialist care. The GP is the front line. They are based not in hospitals but in clinics and practices most often based in or near residential areas. They deal with minor illnesses, or refer patients with more serious complaints to fellow doctors who specialise in the relevant field. There are around 35,000 practicing GPs in England. This is lower than other European countries and in recent years there has been consistent concern about a shortage of these doctors.
The British Medical Association says:
The NHS is currently experiencing some of the most severe pressures in its 70-year history.
GP surgeries across the country are experiencing significant and growing strain with rising demand, practices struggling to recruit staff, and patients having to wait longer for appointments.
Alongside these long-term trends, GP practices have been at the forefront of the NHS’s response to the COVID-19 outbreak whilst maintaining non-COVID care for patients throughout.
This may be true, and there may be a staff shortage in the health service, but that has little bearing on the latest scandal. (That the health service appears to suffer staff shortages so regularly is an indictment both on NHS morale and, arguably, our education and recruitment structures).
This week’s news reports that GPs are threatening industrial action.
This isn’t a unique scenario. Back in 2012, they went on strike over plans to increase their retirement age from 65 to 68. While some understood their grievances, others believed that this is a highly paid, high status group who are far better off than most. Importantly, some expressed the view that doctors are in a unique position; their work is vocational, they have a duty to care for patients. Indeed, doctors are honour-bound to stick to their famous ‘first do no harm’ promise.
All of this aside, the reason for today’s threat of industrial action is, on the face of it, truly extraordinary. GPs are threatening industrial action because the government wants them to see patients.
According to the Guardian:
GPs in England are threatening industrial action in protest at the government’s attempt to force them to see any patient who wants a face-to-face appointment.
The British Medical Association’s GPs committee voted unanimously to reject the plan by the health secretary, Sajid Javid, which included “naming and shaming” surgeries that see too few patients in person.
The doctors’ union has decided to hold a ballot on possible industrial action, which could result in family doctors at the 6,600 practices in England reducing the work they undertake.
How did we get to this? It seems that doctors have got used to not seeing patients. This is yet another negative impact of COVID 19. During the lockdown and beyond, patients were ‘seen’ by doctors over the internet, or were spoken to on the phone. This is a completely ineffective way to obtain medical care. I’ve experienced myself the absolute struggle involved in trying to see an NHS GP. People I know have experienced the same, and others have told me shocking stories (including receiving physiotherapy via zoom call!) Even securing a video or phone call is difficult. Our health service has completely changed and it is dramatically less effective.
In an apparent attempt to address this, the government is demanding that GPs now see patients face to face when they request it. In response, doctors are threatening to see even fewer.
Regardless of minutiae of this argument, that in itself is unacceptable. It is even more unacceptable when we consider the 6 figure salary of most GPs. They are paid that 6 figure salary to see patients, are they not?
It gets even more egregious when we take in to account the extra cash GPs have been taking home lately. On top of their salaries, these doctors receive just over £12 for every COVID vaccination they administer. There have been around 85 million jabs given out so far, with more than two thirds of these by GPs. That’s a lot of money. GPs are not poor.
There is a debate around the government’s idea of naming and shaming GPs that won’t see enough patients, some may consider this troublesome, but we wouldn’t be in this position if GPs would agree to do the job they are handsomely paid for.
There will be little to no public sympathy for doctors on this issue, and rightly so. The result will be even greater alienation and distrust between doctor and patient. Even more people will go without medical treatment, more people will become seriously ill, and more people will die.
Far from ‘first do no harm’, doctors will do real damage with this action, and the public won’t forgive them for it.
Anne Marie Waters
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