“There are two primary choices in life: to accept conditions as they exist, or accept the responsibility for changing them” - Denis Waitley.
We are seeing a mirror image of what has happened in America with medicare/medicaid bureaucracy driving family physicians to despair and burnout. One family physician in Oregon has come up with a solution called the Ideal Medical Practice movement which has been emulated by over 500 family practices across America. http://www.thedailybeast.com/articles/2014/04/29/the-health-care-system-is-so-broken-it-s-time-for-doctors-to-strike.html.
Even Australia is now buckling under the demand for free medicare. http://m.smh.com.au/federal-politics/political-news/free-health-care-in-governments-sights-for-cuts-peter-dutton-signals-in-speech-20140501-zr1ze.html.
Semi-private healthcare in the hands of GPs and consultants, not managers or private corporations
The solution must be evolution, a transition to a model of healthcare adopted by Ireland, Canada and Australia, semi-private healthcare. We must keep our GPs in the UK by bringing Australian healthcare systems to the UK. Private income may then subsidize state income. If we do nothing, then NHS GP partnerships will fold in a domino effect and patients will be left without access to primary care (except those who have access to a private GP). The knock-on effect is that secondary care, ie NHS hospitals will close next and finally the National Health Service. The cost of private healthcare in the US is escalating. The only win:win is to allow a form of semi-private healthcare so that GPs and hospital consultants are in charge of patient rates (self pay or government means-assisted insurance) and not solely health insurance giants or private companies who may choose profits over patients.
The End of NHS General Practice
NHS GP Partners Call to Arms.
'General Practice is being slowly destroyed by a government feeding expectations to a ravenous thankless public. I retired at 55, not a moment too soon. I would counsel young Doctors to stay away from the profession...at least for the foreseeable future.'
'I'm in my early 40s..I can't retire...currently a locum..a locum used to be a GP looking for a partnership, now it's more likely a GP looking for an exit from the NHS.'
'A complicated funding stream, over inspection, and a demoralised workforce with no control is turning Primary Care into an Orwellian nightmare. If we did mass resign (as my dentist sister who lives a lifestyle I will never afford in this sorry state of affairs did), the whole NHS will collapse. However with the way I and most of my peers feel at the moment we are being pushed into saying 's*d it!'
'when you do ballot for a strike,..please ban all over 50s from voting at all because they are already well on their path to retirement anyway,' younger GP partner at the mercy of her coasting towards retirement senior partners.
'I have finally had enough...and will be retiring later this year. I think doctors with skill will survive, very possibly as private GPs but there's going to be some very sticky months between now and then.'
'I am over 50...and took strike action last year. I think you will find that a lot of people simply resign and walk away rather than fight.'
'The elephant in the room is the gulf between workforce and demand.'
'I think GPs will vote for mass resignation IF there is a specific proposal on the table...if current workload continues and worsens and there is no increase in the pay per capitation to a realistic amount then GPs should be allowed to negotiate either a 1) pay per consultation fee, 2) charge for DNA's, visits or appointments above a certain number a year directly to patients or the government.'
'The workload is unsustainable and we have less than 1500 patients/FT GP in a inner city practice. It is likely to be worse in many practices. I would STRONGLY support any decision to quit the NHS. Right now we can't see patients privately either that is allowed or we quit NHS en masse. Everyone is aware there is less money to spend in times of austerity and hence the win-win for both the Governmebt and us...lots to gain by allowing us to see patients privately outside each GP's working hours just like consultants are allowed to. The alternative is to consider changing our surgery to a charity and let the patient participation group decide on our remuneration if any!'
'Safe - what is safe? I have done over 700 weekends starting at fri 9 am to mon 5 pm - 80 hours with little or no sleep. This NHS has never ever been safe - it has always run on doctors working to the bone. Who will define safety in patient numbers seen and consultation times. If not us, Why NOT?'
'Three years ago when I was made enough to join my local CCG Board I suggested that A and E departments should be paid for seeing minor injuries at the same rate as GPs were paid and that I did not understand why a review of a sprain was paid at a higher rate in A and E compared to GPs. I immediately got told off for daring to suggest such a thing. 2 other GPs on my board then immediately disciplined me and I was told that I could not be trusted to work closely with the local DGH managers as they were "upset" by my remarks. This year our CCG board is making us code all minor injuries to see if we deserve any payment at all for seeing minor injuries. So instead of questioning the payments hospitals receive, it's our payments that are in doubt which are tiny compared to the hospitals. This scheme like many others are successful because GPs are able to get things done cheaper and unfortunately many of our CCG colleagues (may) be in cahoots with hospital managers in order to save money by exploiting GPs goodwill and dumping more and more stuff on our doorstep. This project is yet another example of GPs being used by the system. It's time to say no. I feel really sorry for Manchester GPs. We cannot wait for the motion and to be able to say to our CCG "leaders", the public and the government, that we have had enough and wish to resign from the NHS.'
'I retired much earlier than I had planned (to live a less materialistic but greatly more satisfying life) mainly because of the rise of telephone triage. The only way we could manage demand for appointments was to triage all appointment requests. My all time record was 130 calls (plus scripts, results, the odd home visits and walk-in). I used to lie awake at night worrying about all the wrong decisions I might have made. It seems inevitable that as demand grows, more practices will be forced into this way of working. Prescribing over the phone without face to face assessment is asking for trouble. I sleep much better now, going to bed knowing I'm not going to be gambling with someone's life.'