I know you like a few factoids, so, just for you;
Over 800 chain restaurants have closed due to Covid. By the look of some of them, I’d guess they are no great loss to the local authority’s public health department, or global nutrition.
Nevertheless, each closure is hard to swallow, if you’ve lost your job and it’s one more link out of the supply chain.
Here’s another one.
We have closed almost 800 libraries since 2010. That’s about a fifth over the last 10 years. There’s been an almost thirty percent decline in spend.
This is a tough read for the librarians, cleaners, admin staff and the book industry, who’ve all lost out.
One more.
Between 2013 and today, almost 800 GP practices have closed.
We also know nearly 800 GPs have moved overseas in the past six or seven years and…
… the number of fully-qualified, full-time-equivalent GPs, working in England, dropped by 651 between June 2019 and June 2020. I’d guess the number could be closer to 800, today.
The upshot means about two and a half million people have been shunted off to another practice …
… a lot of highly trained professionals have stopped looking after people, or are writing prescriptions and the odd postcard back to Blighty, with a view of the beach, out of the window.
Being a GP must be the best of jobs and the worst of jobs.
The highs of spotting a sinister symptom and saving a life and the drudgery of putting up with another old Linctus-lout, like me, with lumbago.
The best of times when the system works, you can get the staff, patients flow through the system, their results arrive, their notes are clear and the sun is shining.
And, the worst of times when HMG make more ridiculous demands, the Daily Mail has another, baseless rant. The system grinds to a halt and one day, the little voice inside you says… enough.
I can’t imagine what a privilege it must be to be a GP. To be the silent partner in a life, put back on the rails, reliving hope and the joy of wellness.
I can imagine the drudgery of being the sink-hole of the NHS, the target of the tabloids and at the beck-n-call of the latest SoS, and bonkers ideas.
If the health-trade press and the BMA are correct, primary care is not a happy place and the numbers are all on-the-slide.
Too few GPs to many ‘customers’, means ‘over-trading’, melting budgets and hacked off staff.
We are in ‘something must be done’, territory.
Throwing more money is the usual answer. The patchwork quilt of reimbursement gets wider and thinner.
GPs, self-employed, running small businesses, taking the risk is a legacy of a frustrated Bevan who had to settle for what today, would be Uber-Doc.
GPs refused to become part of the NHS. At the time the BMA said they would become ‘little more than common servants’, if they did.
According to the £walled Times newspaper (Work-around here). No19 is going to sort all this out.
Groan…
The Times tells us that GPs are going to be nationalised. Where the legislation is coming from, how the buy-outs will be funded and what happens to practices who say ‘no’…
…dunno.
If it happens, I’d guess there would be quite a few takers. GPs have defied the common-laws of business gravity for years.
They are self-employed but have only one customer and a state pension… they are clearly not self-employed but HMT appear not to want to change that particular prescription.
Fixed hours, a decent pension, a company car, guaranteed annual leave and study-time is a fair swap for all the hassle of pushing a small business up the hill.
I doubt No19 will pull it off.
There is another, smarter, easier solution. The Wonderful Wolverhampton Trust has vertically integrated local practices.
They’ve taken over 18 practices, covering 100,000 patients, with GP partners becoming salaried employees.
They manage back-office, sort-out patient pathways, training and create collegiate working…
… recognising patients make no distinction between primary and secondary care.
No19 wants more of that.
The problem is, once the DH get involved in scaling up a good idea, everything silts up with business cases, plans, rows, accountable officers and death by bureaucracy.
I’m not holding my breath.
News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.
