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GP Debate

Friday 4 October 2013, 16:11

Chris Hunter Chris Hunter Assistant Editor

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What do you think of your GP? What does your GP think of you?

That’s what we want to find out on Tuesday morning. 

At seven, we’ll have the first national broadcast interview with Professor Steve Field, who’s just taken up his role as the first Chief Inspector of England’s GPs; he’s warned general practitioners that he’ll close their surgeries if they’re not giving their patients the treatment they need, so we’ll ask him what makes for a good doctors’ – and how bad one would have to be for him to shut it down.

He takes up his job at an interesting time – this is from the British Medical Association: “Family doctors feel increasingly fed up, overworked, tied up in red tape and worried that ‘dubious’ Government targets are stopping them treating needier patients…86% suffered a drop in morale over the past year.”

While this comes from the Patients Association: “Only six out of ten patients believe their GP treats them with compassion…39.3% rated their GP’s communication skills at five out of ten or less.”

So after we’ve spoken to Professor Field, for the rest of the morning we’re bringing together patients, politicians and practitioners to tell each other how things look from their perspective. 

We’ll try to get to the bottom of the most controversial questions in front line medicine:

How hard is it to get appointments? How good is out-of-hours care? Are GPs responsible for a crisis in A+E departments? Do you even know who your GP is, or are you seen by whoever’s available at the time in a multi-doctor practice?

Of course, we need your input and stories. We want to hear what infuriates you about your GP, wherever you are in the UK:

Do you have to take time off work to get an appointment? Is it impossible to get through on the phone? 

But we also want to know about the good ones – tell us about the doctors you rely on, who have helped you through some of life’s most stressful times – and who have saved your lives.

Professor Field has promised that he’ll be listening and will take up any cases that he thinks need to be acted on – so get in touch and listen from seven on Tuesday morning.

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  • rate this
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    Comment number 1.

    My previous GP's surgery removed me from their list from complaining to the Primary Care Trust about a whole host of difficulties I experienced with them over the course of 15 years. The complaints ranged from the poor levels of communication and being treated with a complete lack or respect, to the GP's personal views being prioritized over that of the patient's needs to the denial of services as I was unable to make the journey to the surgery (I was confined to a wheelchair after a car accident and therefore unable to walk, and drive). Central to problem with GPs is the issue of competency. It is my understanding that whilst competence is appropriate ability and knowledge, it is also knowing where your limitations are. I truly believe that the GPs I have had the misfortune of encountering suffer from a distinct lack of competence. Their knowledge is too general to be practically useful and they are rarely prepared to refer to get a specialist's opinion. An example of this was highlighted when I attended the GP surgery to report regular instances of debilitating migraines, instances of falling (down stairs and whilst walking) and periods of time that I couldn't recall. This was within 6 months of being discharged from hospital after a serious RTA. As it transpires, the GP "forgot" to refer me to a neurologist, who I had since sourced privately. In spite of the GP, the private access to the neurologist led to a diagnosis of an acquired brain injury and competent advice on how to live with it.
    Since being removed from the GP's list, I have not enrolled with another GP. In my view, they are incompetent individuals with a 'god-like' complex. They are more of a barrier to treatment than access.

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    Comment number 2.

    My surgery is Crawley Down Health Centre in West Sussex. It is very well run and because it is in what is known as a ‘defined controlled area’ i.e. rural or semi-rural, it is allowed to and does have its own doctor’s dispensary on the premises. For 30 years I enjoyed trouble free dispensing of my medication from this dispensary. Then, in May 2012 my PCT said this had to stop because they discovered my house was just inside a radius of 1.6km from a local community chemist and dispensing like this is against the law.
    The law, (the origin of which dates back over 100 years), is estimated to effect upwards of 5m patients who use rural doctors dispensing surgeries but are unable to collect their medication from the doctors dispensary and are forced by law, if they live within 1.6km of a local community pharmacy to use that one or another pharmacy. You need to read my blog at: http://dispensingdoctorscampaign.wordpress.com to get the full picture but the government enforces this law against only those living within a 1.6km radius in order to guarantee and safeguard a prescription income stream for rural chemists. Countess Mar was able to get Earl Howe to admit this in a debate in the House of Lords on 16th May 2013 but the government refuses point blank to review or change the law.
    I have nothing against community chemists and welcome their existence in rural areas but funding them in this manner is a completely anti- democratic and deprives patients of their right to "patient choice" and "no decision about me without me" as enshrined in the Health and Social Care Act 2012.

  • rate this
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    Comment number 3.

    My surgery is Crawley Down Health Centre in West Sussex. It is very well run and because it is in what is known as a ‘defined controlled area’ i.e. rural or semi-rural, it is allowed to and does have its own doctor’s dispensary on the premises. For 30 years I enjoyed trouble free dispensing of my medication from this dispensary. Then, in May 2012 my PCT said this had to stop because they discovered my house was just inside a radius of 1.6km from a local community chemist and dispensing like this is against the law.
    The law, (the origin of which dates back over 100 years), is estimated to effect upwards of 5m patients who use rural doctors dispensing surgeries but are unable to collect their medication from the doctors dispensary and are forced by law, if they live within 1.6km of a local community pharmacy to use that one or another pharmacy. The government enforces this law selectively against only those living within a 1.6km radius in order to guarantee and safeguard a prescription income stream for rural chemists. Countess Mar was able to get Earl Howe to admit this in a debate in the House of Lords on 16th May 2013 but the government refuses point blank to review or change the law.
    I have nothing against community chemists and welcome their existence in rural areas but funding them in this manner is a completely anti- democratic and deprives patients of their right to "patient choice" and "no decision about me without me" as enshrined in the Health and Social Care Act 2012.

  • rate this
    +1

    Comment number 4.

    I've been a GP for 25 years and have never known morale amongst my colleagues as low as it is at present. 12-13 hour days are now the norm whilst we try to meet ever increasing demand with dwindling resources. We are trying to keep the NHS running in the face of the chaos arising from the recent reforms, and the need to somehow find £20 billion savings across the NHS over 4 years. We feel as if we're the target of an orchestrated political and media campaign against us, while we are all working harder than ever to help our patients get the care they need. We deal with 90% of the contacts with only 9% of the resources, and despite all the rhetoric of moving care nearer to the patient, our budgets have been steadily eroded and most of us have lost the community nurses who used to be based with us in our surgeries. Recent vacancies for partnerships locally have attracted few if any applicants- whereas a decade or so ago there might have been 200 applying for each job. 27% of the GP workforce are aged over 55, and with unmanageable workloads and plummeting morale, many of these will be leaving the NHS before their own health really begins to suffer. Who would want to be a GP in this environment? British primary care is the envy of the world, but I suspect many will only appreciate this once it has been completely trashed by those who should have protected and nurtured it. The 3 doctors in my practice today had direct contact with over 160 people. If the other 5000 registered patients all decide they also need to be seen today, then clearly we can't cope and people are fully entitled to pitch up at the local A and E, wait 4 hours and be seen in all probability by a less experienced doctor with no knowledge of them or their family, but please don't blame me for that.

  • rate this
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    Comment number 5.

    I have 3 points to make...
    Firstly, every year there are thousands of very bright, high achieving youngsters competing for relatively few places to study medicine at university. Clearly it is a profession to which many aspire. A significantly large number of those studying medicine for 5 years and more will become GPs. Is there not a case for a new style of medical degree which trains GPs and more of them ?

    Secondly, why should I have to make an appointment to see a GP when all I need is something that a Pharmacist could provide? Why not use these skilled health care workers more?

    Finally, to open a Nursing Home you need planning permission, there is no need to consult a local Doctors surgery to identify if there is any chance they could cope with more patients. Surely this needs to change as some doctors are swamped with elderly patients, so there are fewer appointments available for the younger, middle aged working population.

  • rate this
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    Comment number 6.

    I am a GP I am happy to move towards 12 hour opening 7 days a week this represents a 68 % increase in opening hours - no one seems to be acknowledge that this increase will need an increase in funding - who will pay for the lights, heating, extra staff etc. Additionally, if I am open I will and so will my patients expect for all ancillary services to be available - are the government willing or even able to fund this extra increase in routine opening hours?

  • rate this
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    Comment number 7.

    Comment from an average GP
    Was composing a rant in my head cycling to work this morning (too tired to safely drive home last night so walked) ... I only got accosted by one patient on my way in to work before 7am!
    Decided though to make only 3 points;
    1) LITTLE STUFF ... some of the BBC correspondents make out as though I'm solely a referring machine. Thanks for describing 1.5-2% of my job. The other 98+% is spent dealing with problems in totalis as well as around 3hrs paperwork per day (prescriptions, hospital correspondence, insurance reports, blood/xray reports, colleagues queries, administrative issues do not take care of themselves.
    2) BIG STUFF- being a small-medium sizes practice we nonetheless cover 8 residential and nursing homes. These generate a vast amount of work that is never seen by the patient at the counter. My colleagues and I have overseen 35 deaths IN ONE HOME since January involving days (rather than hours) of work, comfort to families and savings of tens of thousands of pounds of precious tax-payers cash avoiding hospital/ hospice admission for end of life care. This is utterly unseen by the patient at the front desk who's complaining that his prescription is not ready 12hrs after requesting it.
    3) Being an issuer of sick notes and hopefully an insightful person I can genuinely say that I have never seen an individual with a more stressful job than my own despite issuing sickness certificate after sickness certificate for people with "work-related stress" over all the employment categories.
    Anyhow back to paperwork... no breaks as ever today... last patient booked in for 8pm.

  • rate this
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    Comment number 8.

    I am a practice nurse - why does no-one mention us in all of this? We do a lot of the work in the practice - see all the chronic disease patients, get all the boxes ticked, see more and more acute patients and yet we seem to be invisible. Its not all about just the gps

  • rate this
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    Comment number 9.

    My daughter who has learning difficulties and often forgets has been struck off from our family doctors for not attaining a appointment and as she doesnt live with me she had no access to a phone to cancel the appountment as the phone didnt have any credit

  • rate this
    +1

    Comment number 10.

    I wrote a two page letter to my GP explaining why the family were leaving the practice, this included a few complaints, most notably my daughter, having to have an afternoon off work for the contraception jab as it was not available in the evening surgery, had to have a second half day because the doctor said she was too busy to walk downstairs to pick up the injection ampule. (10 minute appointment and stairs by her door!!!)
    I am sick of doctors who behave as if patients are an inconvenience, and even more fed up of the wretched reception staff who treat patients as if they are nothing. We moved to a lovely practice, with nice doctors, nice staff and nurses, we all wondered why we had waited so long to move. Two very inner city practices in South London, yet they couldn't be more different.

  • rate this
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    Comment number 11.

    Seeing your GP now is less about the patient and more about dealing with the demands that have arisen over the years. The time when you could always see your GP who you were registered with each time and they knowing your case history when you entered their surgery have been replaced with next. My GP at the moment is a young lady who seems to be on permanent maternity leave so I have to see someone else who hasn't dealt with me before and needs several minutes to look at her notes and ask the same questions over and over before making a diagnosis.It's also harder to get through to see a GP and also when you have been seen at a hospital you know the surgeon the nurses etc you can't get answers that you want from them you have to go through your GP. This amounts to time consuming and not getting the answers that would make you feel happier direct.

 

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