As a GP registrar in London who has recently qualified, this part of my career should be when I am flush with enthusiasm for my new career, looking forward to rewarding years ahead doing what I came into general practice to do: treating patients. Unfortunately, like many young GPs the reality is struggling to match this aspiration: so where did it all go wrong and how do we rectify that gap?
The disappointing reality of general practice is reflected throughout motions for debate at the 30 January special LMCs conference, and has been covered by Dr Richard Vautrey and Dr Krishna Kasaraneni in their articles this week for GPonline. Dr Beth McCarron has also talked about an important resource pack being launched by the BMA which is vital at a time of crisis.
As a younger GP, my biggest concern though is that GP trainee and junior doctor morale is being constantly eroded. A few weeks ago I took part in something I never expected to do: industrial action. This was called by the BMA’s junior doctor committee with a heavy heart after two and half years of talks which ended with a government threat to impose a contract that slashed juniors' pay and gutted parts of the contract that ensure safe working conditions.
Junior doctor strikes
Last week we agreed to suspend the second set of industrial action days, but there is still a gap between the government’s ill-thought out proposals and our desire for a contract that is fair for junior doctors and safe for patients.
I mention this episode as this perfectly avoidable dispute has inevitably taken its toll on the morale of the youngest doctors. And when we look at the landscape for GP trainees with an overstretched service struggling with poor staffing levels, it is understandable why many are being lured abroad to sunnier, better resourced health systems.
From my perspective, I feel we need a cultural and practical shift to address this situation. The practical is obvious: we need a better resourced, better staffed general practice that gives patients the service they deserve. But we also need politicians of all parties to stop their demoralising habit of over promising what GP and wider NHS services can deliver without having the faintest idea of how that will be achieved.
Seven-day GP services
The junior doctor dispute is just one example of this, another hanging in the background is the government’s stumbling seven-day services proposals. I could spend another 1,000 words unpicking the issues with patient demand and resources, but perhaps the most galling is the government’s promise to deliver 5,000 extra GPs.
With 600 vacancies for GP trainee positions this year and a third of GPs talking about retiring in the next five years this would be hard enough to achieve – and that’s before the blatantly obvious fact that it takes eight to 10 years to train a GP. And that is my point, why make a promise, why raise expectations, why put more pressure on GPs, with an election promise that physically can’t be achieved?
If we are to recapture the next generation’s enthusiasm for general practice we need a new political consensus. One where politicians' promises and actions match the reality on the ground. There is still time to achieve this, but this cultural change needs to happen fast.
Dr Bea Bakshi is a member of the GPC GP trainees subcommittee