By Andy Drane
UK GPs have been under increasing pressure from the pandemic due to a backlog of NHS treatment for non-Covid ailments as well as remote patient contact and increased staff absences. A December poll in GPonline revealed that a third of GPs were facing "very high" levels of work-related pressure, a situation likely to worsen as the UK endures its second wave of coronavirus.
While the added pressure brought on by the pandemic has triggered an immediate crisis for many within the profession, the environment for most GPs has been extremely challenging for many years, with numerous legacy issues still needing to be addressed beyond this current public health crisis.
A lack of sufficient numbers of newly qualified GP candidates sits at the heart of the problem. It takes years to address this issue, meaning the UK public faces a decline in care standards or having to recruit additional experienced doctors from abroad, a costly process which denies poorer nations of much-needed medical skills.
Here in Scotland, GP recruitment has been further set back by the Scottish Government’s attempted integration o health and social care alongside the implementation of its new GP contract. Under the new agreement, GP practices will continue to operate as private businesses with the partners’ remuneration dependent on their level of profitability.
The new agreement offers further Government support, in principle, by removing some of the risk burden from GP practice partners in running a business. It also provides more funding and reinstates the principle that doctors are expert medical generalists who should only focus on those patients who actually need to be seen by them.
Some health boards are attempting to implement these policies but this has not been consistent across Scotland and progress has been slow. While this may be understandable in the current climate, failure to creating a stable working environment for GPs will lead to increased shortages and could trigger wider public health issues. The Scottish Government must therefore ensure all health boards take a consistent approach in implementing the new contract.There are also UK-wide issues for the Westminster Government to address which are currently preventing older GPs from working. While the Chancellor’s March 2020 Budget took some steps towards addressing doctors’ pensions earnings, issues around lifetime allowance limits still remain which are penalising experienced GPs who want to continue working beyond their retirement age.
Further measures to incentivise medical students into a general practice career are also needed along with rules requiring UK-trained doctors to remain working here for a minimum post-qualifying period.
Along with the challenges it has brought to the profession, Covid also presents a real opportunity to revitalise GP service delivery through new, imaginative policies which will benefit those in the profession along with the wider public. However, Scottish and UK governments must firstly focus on removing the increasing level of burden that many doctors are currently facing.
Given the essential role of GPs in safeguarding public health, politicians and policy-makers must ensure this is a key health priority.
Andy Drane is partner and GP practice adviser at law firm Davidson Chalmers Stewart
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