No GPs?

I was sceptical about my doctors (within walking distance) stating if you need an appointment you have to log in to their website state what you have wrong with you and what you would like to happen but I've nothing but praise for this system now, if they think your appointment is urgent you get an appointment same day or a doctors phone call or a referral.

To train a doctor in the Uk is expensive. Both for the government and for the student.

www.telegraph.co.uk/health-fitness/body/junior-doctors-nhs-true-cost/

fancythat

To train a doctor in the Uk is expensive. Both for the government and for the student.

It is, but if we (as a society) knew that the money wasn't being sent abroad it would make sense to invest in training more (and more nurses, radiographers etc). I can't see why a contract such as I described in my previous post wouldn't benefit everyone. No debt for the medics, and a guarantee that expertise will stay here or the expense of providing it reimbursed would be a win-win situation.

Doodledog

fancythat

To train a doctor in the Uk is expensive. Both for the government and for the student.

It is, but if we (as a society) knew that the money wasn't being sent abroad it would make sense to invest in training more (and more nurses, radiographers etc). I can't see why a contract such as I described in my previous post wouldn't benefit everyone. No debt for the medics, and a guarantee that expertise will stay here or the expense of providing it reimbursed would be a win-win situation.

The vast majority of doctors remain in training posts in the UK after qualification already Doodledog, they tend to leave in their thirties, by which time they have worked for the NHS already for around 10 years. They have large student loans because of the length of their training, which they also pay back as deductions from their monthly salary. I think by the time they do emigrate if they decide to, that the UK has already had its pound of flesh. We need to make working for the NHS an attractive option, not punish them for leaving a system that destroys them in its current form.

I'm not thinking in terms of pounds of flesh or punishment. They are your terms.

As I said, I would scrap the fees, so they wouldn't have student loans, and their taxes would pay for the same things as yours or mine. I think it should at least be discussed as part of a solution to the lack of staff, whether in recruitment or retention. It needn't rule out looking for other ways to reduce workloads and the stress they are under, but it would give the NHS some stability.

Sylvia
You have accurately summed up the situation. I don’t mind if my doctor comes from Africa though, not sure why you mind. I do object to us poaching medics from abroad though, I think it’s immoral.
My daughter is a doctor and has experienced abusive patients. As you say, I wonder how members of the government would feel about their adult child being abused at work.
The government are doing nothing to resolve the GP shortage. They are doing nothing to resolve the problem with junior doctors pay, which has been eroded for about 14 years as I understand it.
My daughter has gone to New Zealand to work and to escape the working conditions in the UK. Many doctors, especially GPs are leaving to work abroad and the government apparently don’t think think this is a problem.

Doodledog

I'm not thinking in terms of pounds of flesh or punishment. They are your terms.

As I said, I would scrap the fees, so they wouldn't have student loans, and their taxes would pay for the same things as yours or mine. I think it should at least be discussed as part of a solution to the lack of staff, whether in recruitment or retention. It needn't rule out looking for other ways to reduce workloads and the stress they are under, but it would give the NHS some stability.

I know they were my terms, I feel desperately sorry for doctors in the current environment. If you adopt a no fees approach for people training to be doctors, I assume you feel that should extend to other health professionals who are also in short supply, I’d agree in principle with that rather than the current bursary system, but it would cost a lot to do of course - and other groups may lobby for similar treatment.
There has to be a robust selection process, there’s about a 10% drop out rate at the moment, and it’s likely that more people who are not suited to be doctors would apply and the dropout rate would increase. The big barrier for people from lower income families would still be the accommodation and living costs charges - are you proposing they pay for those on a similar basis to now?

Sorry, I should have added, that even if all those plans came to fruition, there will still be recruitment issues in general practice, because it isn’t, for many reasons, a popular career path for doctors now.

Casdon are you reading my posts before you criticise them?

I did say that I would extend free tuition to other medical professionals and that higher recruitment should be done without diluting quality.

I did read the whole thread including your posts, but I must admit I can’t identify that you said that specifically about other healthcare professionals, apologies. I wasn’t criticising, but I am trying to understand exactly what you’re proposing in detail. I’m heavily invested in maintaining the NHS, having worked in it for so many years I can see many of the issues, and there certainly aren’t easy answers, medical staffing being one of the most difficult of all, as of course it has been since before the NHS came into being.

This is from my post above (on this page at 11:48:23).

It is, but if we (as a society) knew that the money wasn't being sent abroad it would make sense to invest in training more (and more nurses, radiographers etc).

I'm not saying that a contract would be the answer to all the problems in the NHS, but that it would be a starting point that would allow future planning and to keep some of the money spent on training in the UK.

Yes, I did see that, but I didn’t appreciate that you were implying that those staff groups would be employed on similar terms to your proposals for doctors, I read it that more would be needed - crossed wires I think.

Easily done

I really don't think you improve retention with punitive measures, you do it by improving working conditions, pay and demonstrating that an employee is valued. fwiw nearly 800 newly qualified doctors failed to obtain a foundation year one training place in 2022. Some of them will have gone to work abroad as they wouldn't have the necessary registration to work as a doctor in the UK. What does that say about how we value the training they have received? However, this is a situation which will continue to worsen as we put more students through medical schools. Competition to obtain specialist training posts is fierce and often doctors are left marking time before they can progress their training so they opt to leave the country and tbh I don't blame them! No problem getting on GP training courses though if you are prepared to move to one of the areas where it's difficult to recruit GPs. They get a £20K hello and provided they stay 3 years they don't have to pay it back. The attached shows the Targeted enhanced recruitment areas you might be interested to see how many areas are covered by it.
medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/general-practice-gp/how-to-apply-for-gp-specialty-training/targeted-enhanced-recruitment-scheme

Oh my Lord foxie, my daughter would have loved that, a twenty k inducement. She received no inducement, nor her (now ex) husband.
I agree with you totally, we absolutely should not be even suggesting punitive measures in order to recruit GPs or doctors in general. What a horrible idea. We don’t own them. They pay for their university tuition exactly the same as other students, but many other students graduate after three years (not the six my daughter spent at university) and then go on into private industry, where they earn far more in a lifetime than most doctors. Sometimes they have to agree to stay for six months, or even a couple of years, but essentially they work and earn for themselves. If they want to take their skills abroad, they can do. Where this idea that we somehow own doctors because we paid for their education originates from, I don’t know, but we pay for every other student’s education too, and no one suggests they pay it back, beyond what they already pay.
We paid our daughter’s accommodation, books, food, and all other expenses whilst she was at university and it cost us about ten thousand a year because she was at university in London. Perhaps the NHS should pay me back!

Incidentally she worked for fourteen years in the NHS before she left for New Zealand. She doesn’t owe any of us a penny!

Thanks for all your kind comments re my pancreatic cancer diagnosis. Sadly I didn’t have heartburn symptoms but rather an unusual back ache. I am sure a face to face appointment would have been helpful. But I am one of the lucky ones. 75% of people diagnosed with pancan are dead within a year. I’m still here after 19months. 🥳

Oh dear what is happening to the world? I have not had any medical needs since 2019 (broken ankle) except once in February 2022 which took me weeks to set up online as it was impossible to choose the right option (they conveniently missed out 'one to one'' on the list) I finally got a phone appointment with a practice nurse after 2 weeks who made me the GP appointment that I knew I needed the following week. Today I have spent over an hour trying again online as all I want is another prescription for a cream I know works on my insect bites. Nothing of any kind available in the next 16 weeks. I found a telephone number and the polite lady got me a telephone pharmacist appointment in a week, out of hours. After I had explained the impossibility of making any appointments online she then said I might then have to make a GP appointment Aaargh!!!! She also told me my prescription for the skin cream years ago was listed as for migraines!! Oh isn't technology wonderful?!

henetha

I truly don't feel that I have a doctor at all now. My old GP retired six years ago and I was assigned to a new one and I have yet to set eyes on him. On the rare occasions that I have needed to see a doctor in the last few years it's always a different one. And now it is even more difficult to get an appointment at all. So I generally don't bother. I'd rather google things and then buy medications online. Obviously I would not do this if it was something serious, but for many everyday problems it is perfectly satisfactory.
I feel somewhat cynical about the whole GP thing.

I think it is a perfectly reasonable expectation that we all take care of our everyday, minor health problems in this way, perhaps seeking the advice of a pharmacist. As you say, you would contact your doctor for any problem which appeared to be more serious which you could not resolve for yourself, and that is exactly how the GP service should be used.

Why is it 'punitive' to pay for someone's training in return for their staying in the country that paid for it?

maddyone what really makes me angry is that people blame doctors for the mess that's the NHS is in. It's like blaming the fish in the sea for dying because of pollution. Doctors are as much victims as their patients, they are not responsible for the problems but whilst most of them keep swimming some decide to get out of the water! Young doctors do not want to be GPs, they all get a lot of exposure to primary care in their medical training and what they experience completely puts them off. I think the question is "why" not how can we force them to stay in practice. A huge amount of worthwhile primary care work can, quite properly, be handled by nurses and other specialists who are not doctors. However, some patients seem to feel they've been "short changed" if they don't see a doctor. I was seen by a young GP and told I'd got late onset asthma and was given steroids, I saw the practice asthma nurse, did a peek flow test, she said definitely not asthma and she was correct. I re-injured an achilles tendon, GP called in the physio to look at it saying "she's the expert". I think we need to stop blaming doctors for the under funding of the NHS and put that blame where it lies which is squarely at the door of our current govt and if we need to pay more into the NHS, then let's get on and do it.

foxie I completely agree with you, but I know that you know that already. The problem is underfunding. When the last Labour government was in power, the NHS improved considerably because they put so much more money into it. I know lack of money isn’t the only problem, but it is the main problem in my opinion. And holding down the salaries of doctors as this government has done is merely making more doctors leave. Improve salaries and conditions and fewer would leave. That is how you maintain a workforce, not by forcing them to stay, basically saying you owe us because we trained you.
I don’t know how a future Labour government would deal with this, but I worry that it will not do very much due to lack of funds. That worries me.

Doodledog

Why is it 'punitive' to pay for someone's training in return for their staying in the country that paid for it?

My daughter worked in the NHS for fourteen years after she qualified. Is that enough?
(She also worked in clinical practice for the last two years of her training. Whilst she was learning, she was also doing much of the routine work so that more qualified doctors didn’t need to do those more routine things.) So a total of sixteen years including those two on clinical practice. Is that enough?

That’s interesting foxie. My town is on the list. Now I know why we can’t get a gp appointment without jumping through many hoops, and I can’t jump these days. 🙁
My dd has worked nearly 25 years in the nhs so I know how difficult it is.