Dr Kailash Chand: We need more GPs, more healthcare professionals and bigger premises

Most GPs arrive in their surgery between 7.30 and 8am and are immediately confronted by a pile of correspondence containing dozens of lab results of blood tests and hospital letters detailing the outcome of patients' specialist treatment and progress, writes BMA deputy chairman Dr Kailash Chand.

Dr Chand: 'We are fortunate to live in a country with universal, state-funded healthcare.' Pic: Michele Jones
Dr Chand: 'We are fortunate to live in a country with universal, state-funded healthcare.' Pic: Michele Jones

There is a pile of repeat prescriptions, usually about 100, each of which needs to be checked before it can be approved and signed. In a typical morning  a GP sees up to 30 patients.

GPs are able to meet 90% of the health needs of the population, with the ability to refer on for specialist advice where needed. Doctors are expected to spend between eight and 10 minutes with each patient, but some people need less and others need half an hour. The morning surgery lasts until about noon after which a GP spends another hour on paperwork before leaving for home visits at 1pm.

At 2pm, it's time for a brief lunch. Afternoon surgery begins at 4pm but before that there is much to fit in, with practice meetings and calls from hospital consultants.

It is worth remembering that if you see your GP today and they think you may have a cancer, then you will be seen by a specialist within the next two weeks, and that if you are referred for anything else you will have been treated within four months of that referral.

We have superlative trust and satisfaction ratings that tower over our hospital colleagues

The British population can access all of this regardless of their ability to pay. No one is asked to fill out an insurance form before they can be seen by a doctor or nurse, or asked for his or her credit card details. Primary care receives only 8% of the total NHS budget yet it carries out 90% of patient consultations.

There is no doubt that we have variation in standards of primary care which needs addressing. However, by and large, the primary care model in the UK is undoubtedly one of the best, where we comprehensively provide the entire spectrum of clinical care without exception, from baby checks to the elderly, managing chronic diseases such as diabetes, coronary heart disease, heart failure, epilepsy, even renal disease, which would be completely alien to GPs in other countries.

There is no international parallel to the information being systematically recorded with registers and exemplary standards of care, via the QOF.

We have superlative trust and satisfaction ratings that tower over our hospital colleagues, and patients see us as advocates, helping them through thick and thin, from stress at work to coping with grief, with patients even resorting to phoning us from A&E or a hospital bed, pleading with us to sort out their plight.

A fixed amount for an unlimited number of consultations or visits per year

When the system fails anywhere, from an ambulance not turning up, to a hospital appointment cancelled, or a disability benefit being refused, it's us they turn to. It's the GPs' door where the buck stops. We're paid just £70 per patient to do all this, a fixed amount for an unlimited number of consultations or visits per year.

Moreover, we do this with fewer GPs per head than most of Europe. I challenge any government to find a model anywhere in the world that can match the range, remit and responsibly that we take on and provide as British GPs. Now we are taking additional hospital services, such as minor operations and diagnostic services in the primary care setting.

We are truly fortunate to live in a country with universal, state-funded healthcare. The people of the UK are healthier and safer because of the one of the best primary care system we have. It is high time politicians and policymakers started respecting and valuing what GPs provide, rather than undermining them. What we need is more GPs, more healthcare professionals supporting practices and bigger premises.

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