This morning's short video has now been published. In it I suggest that the truth is that none of us expect to see the doctor now, or anytime soon. And yet, that's absurd because there is serious unemployment among doctors in the UK. That's because the Tories have sacked them. Labour could put 6,000 of them – one for every GP surgery in England – back to work on 5 July. The impact would be enormous. But I very much doubt it will happen.
You can view the video here.
The transcript is:
The doctor will see you now, that's what everybody wants to hear when they go to a GP surgery, and most people don't, of course.
Why?
Well, there aren't appointments available.
Or, when you get to see a GP, or what you think will be a GP, it turns out that the person in question is a physician associate or a paramedic, and they haven't been trained to do the job of a GP, whatever the NHS likes to claim.
So we need new GPs. Labour says it'll take 10 years and deliver them.
But there's a much easier alternative. On the 5th of July, West Streeting could recruit all the 6,000 or so locum GPs who've been made redundant by the NHS over the last year or so. It will cost about a billion pounds a year. But every single GP surgery in the UK could have an extra doctor if he did that.
Will he do it?
I doubt it.
But he should.
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Wes Streeting wholeheartedly ‘accepted’ the homophobic Cass report within days of its publication, without waiting to see how it was generally received (which has been disastrously). Clearly, Streeting is not a man who is either politically or intellectually astute. I fear we are in for a long string of crass, dogma-driven decisions from him, unless the good voters of Ilford North manage to defeat him on Thursday.
Richard, I remember the time fondly when doctors used to do home visits and even at night when urgently required. They knew every family member and my children grew up under their care. They were proper family doctors. Those were the days.
But genuinely impossible now – simply because there is so much more they can do, so demand is very much higher
@Richard – I think it is excellent to make the point that ‘Call the Midwife” and “Doc Martin” style healthcare is no longer possible in England and has not been for some time. This type of healthcare never really existed in the USA. If it did exist in some very rural areas it started dying out after the Civil War and was laid to rest by WWI.
That’s England only.
We have a better system structurally here in Scotland, if still considerably underfunded.
The Tories frequently Labour bash over the Welsh NHS performance but rarely have a go at Scotland.
Yes, we are short of GPs in Scotland, and rural recruitment has been especially difficult in the Outer Hebrides.
And hospital lists are dire for several specialities – orthopaedics being critical.
I’m not sure about how the English unemployed GP numbers are calculated by the BMA, but if there are so many unemployed GPs in England why are they not applying for unfulfilled very well paid Scottish vacancies?
(Our GPs are Welsh, Scots and German, so mobility is not the issue)
Here in rural Argyll I can always see a nurse the same day, have a phone consultation with a GP within 24hrs and a physical appointment in 2-3 days if necessary, so frontline services are very good, (though some aspects of delivery do struggle at times). Okay, so it is 25m to the nearest hospital, but only 40 min by helicopter to Glasgow.
Our nurses are usually overqualified, and have a hotline to the GP if they have any queries, so I have no issues whatsoever at not seeing a GP every time.
In my limited experience of blue light ambulances, just the one suspected sepsis 60+ mph trip, paramedics are very highly qualified for the job they do.
I heard Streeting on R4 AQ yesterday and he is a party apparatchik of the very worst possible type.
Amateurish and evasive are probably the best adjectives. Biddable but not very bright.
Why does he give the impression of a boy in short trousers at a school debating event ?
After that utterly dismal performance I would have zero confidence in him as English Health Secretary.
I can well understand the medical profession worrying about the increased use of associates if they are to be used as cheap unqualified substitutes for doctors, just as non-teaching assistants have been used as substitute teachers, to keep budgets down.
That is a typical “never mind the quality” cynical strategy by a government that doesn’t really give a damn about public services, and to be resisted by all professionals.
However, there is no reason why there is not a valuable role for an intermediately qualified tier, providing demarcation is done by medical professionals. That means taking it away from the political level.
But the English NHS needs restructuring as a public service, not a marketised and fragmented outsourced facility.
“Free at the point of delivery” can so easily conceal a whole nest of serpents.
Sadly, I can only see Streeting delivering at the party political and not public service level.
Much to agree with
Thanks for bringing this to my attention. I knew the system was broken but I didn’t know about this. It has prompted me to do a bit of background reading on the subject:
https://www.personneltoday.com/hr/locum-gps-bma/
https://www.theguardian.com/society/article/2024/jun/21/four-in-five-locum-gps-in-england-unable-to-find-work-bma-study-finds
This article blames the ‘Additional Roles Reimbursement Scheme’ model or ARRS for short, which only funds non-GP roles. I bet some Tory policy wonk had a good old chuckle when they came up with that one!
Streeting says he will ‘review it’
Which means nothing
Sitting around waiting for engine spare parts allows me a chance to catch up on the blog. I have missed it while at sea.
Trained doctors sitting around willing to work; patients unable to see a doctor. Why? Because the beancounters say no. Appalling.
At the risk of over quoting Keynes,”anything we CAN do, we can afford to do”.
True
I agree with the post. I have a question. Additional GP, using your numbers = £166,000/yr give or take.
35% of that is Tax & NI = £58k (yes I know tax bands etc will make the figure different) which means that the GP would get £108,000.
Let’s imagine that a community (small town?) got together and said stuff it – we will fund an additional GP – out of our own resources.
Should they pay Tax & NI?
As you note, plenty of GPs unemployed – thus not paying NI but still getting access to NHS (for example).
Also, arguably, if citizens had to fund the tax & NI element – they would arguably be paying treble taxation to provide a service that the gov has declined to do. (if the tax & NI was not paid then arguably it would be double taxation – they were taxed once for the service and then had to pay again to have an effective one).
You could extend the argument to teachers etc etc.
If one takes the line that NI & tax is there to recover gov spending – but in this case it is citizens that are spending in lieu of a gov failure – where does that leave taxation?
Extending: Imagine there was a class action along these lines (the gov would no doubt try to levy tax & NI) – this would then expose the role of gov spending and how it is recovered – the medendacious media would have no choice but to cover the class action & describe the arguments – & explanations. Suddenly a large number of people would be seen to have no kit on.
Just an idea. (if there were 2,000 people/families each paying £500 it would cover the cost).
Mike
I have allowed for employer NI and pension contrbution + admin overhead to come to my estimate – which is still a marginal cost as I assume the capacity to locate thesemepopel exists (it does)
I am assumning a salary of less than £100k, FTE
“Let’s imagine that a community (small town?) got together and said stuff it – we will fund an additional GP – out of our own resources.”
Will the “community” cover the malpractice liability insurance or will the GP have to fund this out of his own pocket?
GPs pay their own insurance in the U.K.
It is very expensive.
Reply to Richard… question:…..why? .. do they pay their own insurance?
Given GPs are “the front line” in many cases wrt the NHS? (or perhaps I’m suffering an over dose of common sense?)
Because most are self employed
Hospital doctors have it paid for them
@Richard – That is basically the way malpractice insurance works in the USA too.
As a friend of mine put it “I’m more likely to see a doctor if I order a pizza than if I phone the surgery.”
Ow!
Purely anecdotally,
2 weeks ago tomorrow I had a blood test after beginning to suffer from old blokes Prostate issues, after having rung my GP practice a couple of days previously. The following day my GP phoned me and gave me some pretty bad news (probably cancer) and placed me on a two week rule. Since then I have had an MRI, an Ultrasound scan, a phone consultation with the oncology Nurse, a CT scan and another blood test. On Tuesday I am to see the consultant for the diagnoses and hopefully a treatment plan.
I must say I am amazed at how quickly the system has swung into action, many of the staff I spoke to were obviously very frustrated at the state of the NHS, but most agreed when the chips were down it can be great. Of course the treatment may take months to start but we will see. But credit where it is due.
I have a friend who has recently finished treatment for prostate cancer, seemingly very successfully, and he got an exceptional service.
I hope you do, and good luck.