The Jobbing Doctor comments on today’s story in the Telegraph, which reports that newly qualified GPs are unable to find work as GPs and in one case is driving a taxi to make ends meet. As a salaried doctor myself I really had to comment on this.
It is certainly true that it is difficult to find a partnership nowadays. Ten years ago General Practice was in such dire straits that practices would get a handful of poor candidates when they advertised for partners. No-one wanted the huge workload of being a principal in General Practice responsible for the 24 hour seven day a week care of his or her patients. Good candidates did not walk into a job by any means, but they usually spent a few months locumming while looking for a partnership, and they were willing to move to an area where there was a vacancy. This meant that when GPs qualified they did not struggle to find work.
Since the advent of the new contract General Practice has become a much more attractive career option. With the option to hand over out of hours care to a cooperative, junior hospital doctors realised that General Practice could offer them a satisfying and balanced working life and the competition started rising for GP places. Partners had the option of taking on another partner, to share in the increased workload of the new contract, or of taking on a salaried doctor to do more of the clinical work, while they concentrated on the running of the practice – but in almost all cases, still doing a significant amount of clinical work. GPs have always been independent contractors – they can choose how they want their practice to be run – whether that be a true partnership, or following the lead of the solicitors and accountants and having a tranche of partners who own and run the business, and employing qualified non-partners to take on an exclusively clinical role. Meanwhile there was increased funding for the Department of Health and pressure from the government on training bodies to increase the numbers of GPs qualifying, as well as more freedom for EU doctors to come to the UK to train and work.
It made it much more difficult to find a partnership if that was what you wanted (remembering that just five years ago no-one wanted to be a partner as you had to do a huge amount of out of hours and weekend work). There are still huge numbers of GPs qualifying and now it is not only difficult to find a partnership, but difficult to find any full time employment as a salaried GP. Fewer jobs and more qualified GPs means more unemployed GPs.
I qualified as a GP in the last five years and I am truly grateful to have found a practice to take me on. I have friends who are struggling, like those talked about in the article, to find any work at all, as even the locum work has dried up. I would like to be a partner, but I have every sympathy with the partners in my practice, and others, who simply don’t feel they can take the risk of taking on another partner in the current climate. A single handed practice not far from us is five hundred yards from a walk-in centre which has beeen pencilled in to become a Darzi polyclinic. If this doctor’s patients decide they don’t want traditional GP care and they want to see any-doctor-now then his practice may not survive. Can you blame him for not wanting to take the risk of another partner? He may not even feel able to take on a salaried doctor and will make do with a stream of locums or a not-too-risky part timer.
The real story is more sinister. It’s the current government’s insidious attempt to split and disempower the profession. Increase the number of doctors qualifying but reduce the numbers of positions available. Now you have a bank of desperate doctors who’ll take lower paid salaried work which doesn’t give them any political power. Get the salaried doctors fighting GP partners, get the consultants bitching about the GPs, get the public thinking that GPs are rich moneygrabbers who only care about their next paycheque and that hospitals are only good for catching MRSA, and maybe no-one will notice when Virgin, Tesco and Boots start doing smear tests, diabetes clinics and cataract surgery. Maybe Tesco will want to open a GP centre and will need to find cheap doctors to staff it – and who better than disaffected and broke GPs currently driving taxis? Privatisation by stealth? You betcha.