A Quiet Time for the NHS

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 6^th 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!