Is our NHS already lost

growstuff

Germanshepherdsmum

The trouble is, growstuff, it doesn’t seem to work out as Y hours covered - not in my local GP practice anyway.

But that's because there's a shortage of GPs generally and there are vacancies. Forcing the existing doctors to work more hours won't work, if they're exhausted and/or don't want to work the hours because they have families (or whatever).

The NHS needs to be asking itself why so many GPs want to work part-time for much less pay than they could earn full-time. Maybe a way should be found to make full-time work more attractive.

GPs who work part time in general practice often do so because they have other roles too. In my time I’ve been anaesthetised, gastroscoped and had hospital midwifery care by GPs in their other roles. They also provide NHS medical cover in many community hospitals and hospices, teach, and work shifts for out of hours. Anybody who thinks they are sitting on their bums at home or on the golf course could not be more wrong.

It is obvious that we urgently need to train more doctors.

There are a huge number of well qualified and highly motivated school-leavers being turned away from medical schools.

The Brexit disaster led to many EU doctors going home.

We need to train far more doctors in this country, both school leavers with good exam records and mature students who might become excellent GPs.

Germanshepherdsmum

The trouble is, growstuff, it doesn’t seem to work out as Y hours covered - not in my local GP practice anyway.

But that's because there's a shortage of GPs generally and there are vacancies. Forcing the existing doctors to work more hours won't work, if they're exhausted and/or don't want to work the hours because they have families (or whatever).

The NHS needs to be asking itself why so many GPs want to work part-time for much less pay than they could earn full-time. Maybe a way should be found to make full-time work more attractive.

The trouble is, growstuff, it doesn’t seem to work out as Y hours covered - not in my local GP practice anyway.

I don't understand the complaints about part-time GPs. Surely the point is if a practice has X number of patients, it needs Y number of hours to be covered.

I can't see that it matters if four doctors work full-time or eight doctors work part-time. What I don't want is to be seen by a doctor who is exhausted, so it's almost certainly better to be seen by a doctor who isn't half asleep. and stressed. It's not as though a part-time doctor is paid the same as a full-time doctor.

Yes, you’re correct Doodledog. But really the complaint should be that there aren’t enough GPs. Which there aren’t. Nor enough of any doctors at all.

It's not unreasonable at all. The GP who saw me through my pregnancies worked part-time and that was in the 90s. I think, though, that what people mean is that there is not the cover that there used to be in GP surgeries, when you could get same day appointments, or next day with a doctor of your choice, and someone would come to the house if you had a sick child. If a GP is part-time there should be another one working the other half of the week to make up the shortfall in appointments. That there isn't is not the fault of the part-time GPs, but of the lack of funding, but when people are ill and frightened they won't always stop and think that through. that might not be fair, but it is understandable, I think.

It's not the doctors working part-time who are being complained about really (although sometimes it will seem that way) but it's an expression of frustration and fear that people's health is being put at risk at a time of life when they are highly unlikely to get anything approaching comprehensive medical insurance even if they could afford to do, so after a lifetime of paying into the NHS.

Just seen on another thread a complaint that out of eight GPs only one works full time. All the others are part time.

Constant complaints about part time GPs get on my nerves. Many GPs are women with children. They work part time so they can see their children. Not unreasonable really!

Doctors don’t have lunch breaks. They often don’t eat during their workday. Or go to the toilet. My daughter used to get regular urine infections for that very reason. She is at least able to get to the toilet as a GP although both here in the UK and in New Zealand she isn’t able to take a lunch break. She doesn’t eat most days until she leaves work.

SueDonim

*Foxie*, one of the hospitals dd works in took away their staff room and chairs so they had nowhere to rest even for five minutes or to snatch a bite to eat. It also meant staff had to stand when using the computer system and as the desk levels weren’t the right height for standing at, that caused all sorts of back problems!

People were creative, though, and used sturdy boxes of supplies to sit on but really, you couldn’t make it up, could you?

That is just shockingly awful.
They should have ergonomically designed computer chairs or else there will be even more staff off sick with bad backs, hips etc.

I bet whoever decided that has a proper desk, chair and a proper lunch hour off to be able to go to the canteen.

Heaven only knows, Maisie. To up productivity? 🤔

Good lord, Sue1donim, that's pure sadism. What on earth was the management trying to achieve?

Foxie, one of the hospitals dd works in took away their staff room and chairs so they had nowhere to rest even for five minutes or to snatch a bite to eat. It also meant staff had to stand when using the computer system and as the desk levels weren’t the right height for standing at, that caused all sorts of back problems!

People were creative, though, and used sturdy boxes of supplies to sit on but really, you couldn’t make it up, could you?

I have doctors and nurses in my immediate family,too. They regularly work 12 hour shifts and I mean work, no down time. They deserve every penny they earn as far as I’m concerned. They see and deal with some horrible situations,too.

After having a year in a very busy A&E dept, she was fine but her non medic friend was pretty shaken up. When people compare doctors to other professions like the law, banking etc I just think they are completely unaware of what a lot of doctors deal with day in and day out and how much shift work takes out of them. I know nurses, care workers, paramedics etc do shift work but they aren't required to do complex and difficult procedures on extremely sick patients, then tell the parents of a sick or injured child that he/she is dead, then deal with a cardiac arrest all in the middle of the night! The days of getting a bit of sleep or having a rest during a 12 hour shift are long gone!

I was more thinking of people in general blaming doctors than you personally, Doodledog. They do take a lot of stick both in general terms and personally. I imagine that I am not the only GNetter whose medic relative has tales to tell of being physically assaulted by their patients.

I agree with all you say, Maddy. Heaven knows where it’s all going to end.

Foxie your poor dd - that last is a horrific thing to have experienced, especially coming on top of the other issues.

SueDonim

^Sucking the life out^ is a very good way to describe the current system, Foxie Did your dd graduate at the start of Covid, as mine did? Thrown into the firestorm! There are quite a few of her cohort succumbing to various MH problems now. Her grad year has already been told that they’ll probably be followed up for their entire careers due to the extraordinary circumstances.

I think dd will go back into specialist training but as pointed out, places are not that easy to come by.

Thank you for your words, Maddy. I know the way things are run has had an impact on your entire family, too.

Doodledog I probably agree with you in principle, really. However, at the moment, this is the system medics have been given so they can hardly be blamed for doing what’s best for them. Strangely, no one ever complains about dentists in the same way, though I imagine their training must be be pretty expensive, too.

DD had done F1 and 2, spent a year as an A&E doctor and was in ST1 as an anaesthetist when covid struck. She spent covid years swapping between Intensive care with covid patients and emergency surgical work, she had permanent marks on her face from her PPE. The road she lives in came out to clap, which she said was hugely embarrassing as her neighbours knew she's a medic. Her training post was supposed to be for 3 years but a few months in they changed the training model so after 2 years she needed to find another related job. fwiw, she has never complained, she just accepts it's the job. On one of her days off during Covid, she took a walk with her dog and a man threw himself off the cliff in front of her. She did CPR for 20 minutes until the paramedics arrived even though she knew he was dead. When I asked her why, she said she was waiting for someone to make the call so she could stop because that's what you do!

We have had a two tier system for years.
Our Gp has a list of charges, ear syringing is 35 for 1 ear for example. The nhs only provides the basics. While I agree that teenage girls wanting breast implants should be paid for. Dentistry is terribly expensive, all dentists are both nhs and private, our dentist is only taking new private patients. It is 2000 for an implant and b cause I cant manage that (nhs price )
I have to make do with dentures. I have to go private as I can’t stand measuring for treatment so I have to pay for a scan.
As for as I’m concerned the nhs is utterly finished. Privatise and make it compulsory to have insurance.

Doodledog I probably agree with you in principle, really. However, at the moment, this is the system medics have been given so they can hardly be blamed for doing what’s best for them. Strangely, no one ever complains about dentists in the same way, though I imagine their training must be be pretty expensive, too.
I'm not blaming doctors . I have said that so many times - I am blaming the agencies and private hospitals that 'poach' them.

Maddie I agree with most of your last post. Of course doctors should be able to work part-time, and of course they shouldn't be burnt out, and of course the bottom line is lack of government funding. All of that goes without saying, and it is shameful that things have been allowed to reach this state.

I feel differently about their working in private hospitals unless there is a fee paid by the hospital towards their expensive training, but am not saying that they should be prevented from doing so. There is no point in repeating my reasons for thinking this, as I have done so several times, and it is, to use a well-worn phrase, 'just my opinion' anyway. Yours differs, and that is absolutely fine.

It’s so hard to hear these stories of doctors being burnt out. This has an effect on families too. My daughter has three young children, twins of nine years old and a five year old. When she left for New Zealand they were twins of seven years old and three years old. She was working twelve hours a day at her GP practice which meant when she got home she wasn’t able to see them. She worked part time, three days a week, because she is a mother. This has been regularly criticised on Gransnet, not this thread I don’t think, because posters can’t get a GP appointment and so doctors shouldn’t be allowed to work part time.
The problem of an underfunded NHS and of too few doctors is the fault entirely of the government. Doctors working part time, doctors working for some of their time in private hospitals, or doctors working as locums are not the problem. The government have not funded our NHS properly and they have not trained enough doctors. That’s the problem. No doctor should have to reach burn out and ill health, nor have to go to the other side of the world in order to have a proper work life balance.

Sucking the life out is a very good way to describe the current system, Foxie Did your dd graduate at the start of Covid, as mine did? Thrown into the firestorm! There are quite a few of her cohort succumbing to various MH problems now. Her grad year has already been told that they’ll probably be followed up for their entire careers due to the extraordinary circumstances.

I think dd will go back into specialist training but as pointed out, places are not that easy to come by.

Thank you for your words, Maddy. I know the way things are run has had an impact on your entire family, too.

Doodledog I probably agree with you in principle, really. However, at the moment, this is the system medics have been given so they can hardly be blamed for doing what’s best for them. Strangely, no one ever complains about dentists in the same way, though I imagine their training must be be pretty expensive, too.

SueDonim My daughter has also done locum work this year. Her ST3 year was in a hospital over an hour and a half drive away from where she lived, as she worked 12 hour shifts and needed to be there half an hour before and half an hour after her shift to do handover, she was effectively doing a 13 hour day + 3 hours driving on top (there was no suitable train service), by the time she'd eaten she was ready for bed. When she was doing nights she often slept at the hospital as she felt too tired to drive home safely. She was offered an ST4 training job but it was the other end of the country and she decided not to take it so she has done locum work but also taken some time out to travel, working unpaid as an expedition doctor with a charity. Thankfully she has got a training job for August which was upgraded so she can stay in her own home (initially it looked as if the first year would be 4 and half hours drive away!) I'm sorry your daughter has had a difficult time, tbh I did wonder if dd would continue to locum as it gives her a life whereas her ST3 job just sucked the life out of her!

I believe the BMA requested the cap due to lack of consultants who have retired/gone elsewhere. The government has tried to address that by sorting out the pension problem - now the consultants have joined those wanting higher pay.

Germanshepherdsmum

Wasn’t the shortage of consultant anaesthetists the reason the trainees couldn’t be accommodated? The limit on training places isn’t a political choice at all. There’s no point in studying medicine if there won’t be a consultant to train you.

There is a govt cap on university places, the shortage of training places for post grad doctors is partly a result of a lack of consultants and partly due to a lack of investment in training, both surely come back to govt funding?

I'm sorry to hear what happened to your daughter, Sue. I agree that the system needs to change so that nobody's health is damaged by their work.

I also appreciate that it must be very difficult to see these things as bound together if you have a doctor in the family, but I am looking at them as separate issues. It should be possible to address the working conditions of medical staff, increase their numbers and also prevent companies from profiteering from taking expensively trained staff out of the NHS 'pool'.

This is not to say that the individual NHS workers owe anyone anything, for the gazillions time.