The Royal College of General Practitioners (RCGP) has previously sought to raise awareness of the negativity during medical school training that is associated with becoming a GP. However, a GP, David Turner, has now also spoken out, in a piece written for The Guardian, about the bad-mouthing he feels is ruining general practice for the NHS.
““A GP, eh? Well I guess there are worse things you could do.” That was the only careers advice I got in my final year at medical school.
“I’ve no doubt that bad press does nothing to improve recruitment to our ranks, but the pressures on the family doctor service, which has led to the closure of dozens of practices across the country, has also played its part in making general practice less attractive to medical graduates.
“GP surgeries are not part of the NHS in the way hospitals are. Most surgeries are still small businesses. In most cases the doctors own or rent their premises, they employ and pay their own staff and have all the usual responsibilities of running a business in addition to their work as doctors.”
In his fascinating piece Dr Turner goes on to assert that general practice is being deliberately backed into a corner by falling income and rising costs.
“Income for general practice is falling in real terms year-on-year, while the costs of running a practice are spiralling out of control.
“Furthermore, 90% of all patient contacts in the NHS occur in general practice and in 2017-18 we were predicted to receive 7.29% of the NHS budget – general practice is exceptionally good value for taxpayers’ money.”
In perhaps the most revealing part of his piece Dr Turner touches on the subject of indemnity insurance which he says makes out-of-hours GP work prohibitively costly for GPs.
“All GPs have to pay for medical indemnity insurance out of their own pocket. Due to rising litigation the cost of this has been rising by as much as 25% per year. Personally, my indemnity insurance is over £10,000 per year. For comparison, 16 years ago I was paying around £1,700 indemnity costs per year and my income was higher than now.
“I have met doctors who just do out-of-hours work (deemed more risky) who pay almost double this. Out-of-hours shifts are unfilled in many parts of the country due, in part, to the enormous cost of indemnity insurance making it economically unviable for many doctors.”
Dr Turner finishes his piece by claiming that negativity, spiralling costs together with mandatory appraisals and inspections are aiming to “grind down the current model of general practice until it fails and large private providers can be brought in to take over. Otherwise there is no other conceivable reason why any government would put so much additional strain on such a necessary and already beleaguered service.”