This is the latest issue to hit the NHS and it is very worrying. I wrote this for the Huffington Post. Have a read and see what you think about STPs.....
Saturday, 9 July 2016
400 doctors recently gathered in Belfast for their annual meeting to discuss issues affecting the whole profession. It is a 4 day event and a very busy week discussing issues affecting everyone from medical students up to retired doctors covering medical politics as well as the professional, scientific aspects affecting our day to day work.
GPs were angry this year. Angry at how their branch of practice has seen yet more cuts to their budgets and angry with politicians who make out things are OK when those of us working on the front line of the NHS know it isn’t.
GP surgeries are closing across the country now. GPs can no longer keep going and are handing their keys back to NHS England. What a shocking indictment on our politicians when their policies and funding cuts bring about the closure of much loved and well respected community surgeries. Patients are the ones who lose out and once a surgery closes it will never come back again.
The workload in intolerable with upwards of 60-70 patient contacts a day, 30-40 blood results a day, 20-30 hospital letters to deal with, numerous telephone consultations and a few home visits thrown in for terminally ill patients whom we increasingly care for at home now in their dying days.
Much of this was discussed in Belfast and the profession has demanded a rescue package that will go some way to save our profession from collapse. If nothing comes about by the autumn, then the BMA has been given the go ahead to ask GPs whether they will consider industrial action. This is how bad things have got. General practice used to get around 12% of the NHS pie to fund its work and this has been gradually eroded by our politicians to around 7% now. That is nearly a 50% cut when workload has rocketed and the complexity of the work we do has increased significantly. We now see patients with up to 8 co-morbidities such as diabetes, heart failure, renal disease, hypertension and COPD. Often they are on 10-15 different medications and juggling all of this in a 10 minute appointment is nigh on impossible. The chair of GPC, Dr Chaand Nagpaul, said in his conference speech this was ‘not possible, not sustainable, not safe’.
Dr Napgpaul went on to say how shameful it was that when we are the worlds 6th richest economy that we have some of the lowest number of hospital beds in Europe and very low numbers of doctors and nurses. He accused politicians of ‘savagely slashing NHS funds under self-proclaimed austerity’.
Another big issue at the moment is the junior doctor dispute. We recently saw a ballot of junior doctors and medical students reject the contract by 58% to 42% on a 68% turnout. On the day this was announced the chair of JDC Dr Johann Malawana resigned as he had recommended the contract to his colleagues and given they had rejected it he felt he had to leave. Dr Ellen McCourt was elected chair the next day. Ellen is an A&E trainee from Hull and has a lot of work ahead of her. JDC have decided to survey its membership over what steps they might be prepared to take next. You will have seen that Mr Hunt got up in Parliament days after the result was announced and announced he would be imposing the contract. This has led to a group of junior doctors (Justice 4 Health) consider legal action against the actions of Mr Hunt. We will have to see where all this gets us over the summer.
All this is at a time when the major political parties in turmoil and the country has voted to leave the EU. It is hard to think of a time when so many momentous events have come together at once like this.
One thing we must remember is that our patients must come first in all we do. Despite the savage cuts to the NHS and the dwindling workforce we must do all we can to ensure patients receive safe, high quality care. We must hold to account those who put this aim of ours at risk and speak out on behalf of our patients when we believe we see injustice occurring.
No doubt there will be many more interesting times ahead of us!
Wednesday, 13 April 2016
I arrived at the picket line at Royal Lancaster Infirmary at 8am on Wednesday just as the photographer was arriving to take some pictures for his latest story. There is still significant media interest in the strikes - which are the first set of doctors strikes in 40 years.
The junior doctors had arrived and were getting their banners ready and it was fantastic to see some local teachers turn up to support our doctors. The rain didn’t dent our spirits and we spoke to many passers by who supported us and hundreds of cars honked their horns in support as they drive by.
As a GP I support our junior colleagues 100% in this fight for a safe and fair contract and what is in effect a fight for the NHS. I know they don’t want to be on strike but they have been forced into this by Cameron and Hunt who now see doctors as their enemy and are trying to crush them.
A consultant came out to the picket line and brought coffee for us and I had a chat with him. He said the consultants were showing huge support for the junior doctors and would continue to do so during the next escalation to a full walk out in late April.
In most democracies if a Health Secretary had handled the situation so badly that junior doctors had gone on strike he would have ben sacked. But not in this country. We have a government prepared to bully doctors and force through and implement a contract that is manifestly unsafe, unfair and what we have recently seen is actually discriminatory – to women on the whole.
Junior doctors have been left with no choice as Cameron and Hunt refuse to talk. The doctors are livid at how they have been publicly vilified by politicians prepared to lie about statistics in order to justify their misplaced ideology.
It made me think once more how GPs have it bad at the moment too. With a crushing workload, no time to think or take stock of the 50-60 patients we see at 10 minute intervals each day, the GP profession is on its knees and many are walking away because they can’t continue. 12-14 hour non stop days are the norm and it is killing my specialty. I am so angry at what is being done to what was once the jewel in the crown of the NHS. Many GPs say they no longer feel safe in their day to day work given all the government has piled on us.
In a way I would like GPs to be on strike side by side with our junior colleagues to show the dreadful state the NHS is in due to the neglect of this government. Year on year real cuts to the NHS budget has left the service close to collapse. When the NHS needs 4% increases each year to keep up with the care needed it has been getting 0.9% for the past 6 years.
When the junior doctors change jobs in August (as they do each year) there will be huge gaps in rotas as doctors will have gone abroad or just left medicine. Their morale is so low they do not want to work under this imposed contract. I think some hospitals will seriously struggle to fill rotas leaving doctors to care for ever increasing numbers of patients overnight and making it less and less safe.
The government should be ashamed of itself having brought the service to its knees but they continue to ply us with their lies about the NHS doing well and care improving – when every NHS staff member knows the exact opposite is true.
It is a national scandal. It should see a government fall. It should see millions of us on the streets.
The only way to stop what is happening is to get angry and get active. Join campaigning groups, get family & friends to write to their MPs, write to the local press, oh and above all support your junior doctors and tell them you stand shoulder to shoulder with them.