General practitioner

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A dream career turns into a nightmare

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Mark Corcoran became a GP with a simple dream — to follow in the footsteps of his father.

The Bristol GP had always looked up to a man who was a well-loved local figure, a valued and respected pillar of the community.

But the reality of practising, and serving a community in the NHS of 2016 is almost unrecognisable as the rigours of spiralling waiting lists, dwindling numbers of colleagues and the difficulties of dealing with patients with multiple, complex conditions bite hard.

And now, a health service which often relies on taking mutually agreed advantage of so many good people driven by conscientious and compassionate values, is at risk of losing another one of its frontline heroes. Dr Corcoran, like so many others, is considering his position.

‘My father didn’t force me to become a GP but in a way he made me want to be one,’ Dr Corcoran said, speaking at the BMA annual representative meeting in Belfast.

‘He regularly told me how much he loved his job. I started off like that but my enthusiasm has waned and I am thinking about joining that haemorrhage away from the profession. We’ve become counsellors, priests, life coaches, uninsured lawyers, friends, aunties and uncles but above all we’re family doctors.

'We never leave our patients, we walk with them on life’s journey; celebrating when things go well, comforting when they’re sad, grieving, crying and we take responsibility for them. We do all this for around £75 per patient per year. I spend six times that amount insuring the health of my boxer dog.’


'The NHS will fail'

While GPs may have been making their worries public for some time, the immediacy of the crisis cannot be doubted.

That much was made clear, rather darkly, by the language used at the ARM.

One motion read: ‘If general practice fails, the NHS will fail.'

GPs won strong support across the whole profession.

BMA council chair Mark Porter said after Dr Corcoran’s impassioned speech: ‘The call here is one that resonates throughout this hall and should resonate through our profession and the NHS. We must support our colleagues who are under tremendous pressure.’

Small steps have been taken to address these mammoth concerns raised by GPs.


Drowning in work

NHS England’s Five Year Forward View set out a vision for the future of the NHS and changes are taking place at pace across the country already, with more than one thousand GP practices already involved in new models of care.

But according to Chaand Nagpaul, BMA GPs committee chair, the pressures on general practice have ‘sunk to new depths’ over the last year – leaving doctors drowning in work and unable to cope.

He told the ARM that GPs must ‘fight every day until we resurrect our proud profession’.

He said: ‘Demand escalates relentlessly, with a growing, ageing population with expanding, multiple complex needs. Meanwhile, the explicit wholesale transfer of care out of hospital continues unabated.

'It’s GPs who’re absorbing this burgeoning workload, with 70 million more patients seeing us annually compared to seven years ago and with fewer GPs per head which is drowning our capacity to cope.’


Manageable workload

The BMA has persistently lobbied the Government over the crisis – and has written an Urgent Prescription for General Practice which aims to address the problems facing doctors and provide answers.

It includes proposals for making workloads more manageable, allowing more time with patients and providing additional resources and staff in terms of doctors and allied medical professions.

And last month politicians met with doctors to discuss the challenges facing general practice at a BMA-led event in Westminster.

The event came after NHS England announced its GP Forward View package – which committed to funding rising from £9.6bn this year to more than £12bn by 2021.

While the funding is welcome, doctors are urging investment to come more quickly.

Dr Nagpaul said it was ‘shameful’ that the UK spent a smaller proportion of its national wealth on healthcare than France or Germany. Otherwise, general practice faces a downward spiral.

As Dr Nagpaul put it: ‘A record 201 surgeries closed last year. Unfilled GP vacancies are at their highest, with half of practices struggling to recruit locums to provide essential services. This has led to a toxic mix from which existing GPs can’t wait to escape, and which many young doctors will not join.’

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