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SOS: Save our sanity, salary our service!

An acute shortage of doctors is threatening Rosa’s practice—and her stress level

After 18 months of taking part in the commissioning process I and other GPs involved have pushed for more information, more training, more time and more money. The health authority is receptive and admits that we were thrown in with no real idea of what we were doing. I feel anxious but hopeful.

But after talking with my colleagues in inner Liverpool I am worried. As GPs retire no young idealistic doctors are stepping in to take their place. In fact no one is taking their place at all. Several practices, including ours, have been advertising for ages with no response. We have begun to see patients who cannot find a doctor. One colleague has a list of over 4,000 because he cannot find a partner.

We do have a well established scheme of associate doctors joining practices for three years to help out and put some energy into reaching all these targets. After a gruelling year our practice has secured one of these, which has saved our sanity. The partners, myself included, have been dropping like flies under the pressure.

This is a lovely idea for young doctors to whet their whistles in deprived areas before-as one NHS executive bureaucrat put it-‘they go on to proper jobs’. But the government is worried about it setting a precedent for a salaried service (and a very nice salary at that with free mileage and medical insurance). I hear they are keeping a close eye on Liverpool.

Of course, it is a subversive scheme. If associate doctors can be salaried, why not the rest of us, who are committed to working in deprived areas for a long time? And we want more. We want built in sabbaticals to restore our energy and enthusiasm, free car insurance, built in locum cover for the sabbaticals-and self-development, especially for the smaller practices. Those of us who want to do training, facilitating, teaching medical students, commissioning want the time and space to do it. We want our health centres maintained and secure so that we do not have to see broken glass every morning as we arrive. We want to be valued for what we do: providing good care for people who are poor, disadvantaged, deprived, ill, dying.

Stephen Dorrell said recently in a letter to Ian Bogle of the General Medical Services Committee that he wants to see a ‘vigorous and caring’ profession. But while there may be many positive developments taking place in primary care, some of us are on our last legs.