I always wanted to be a generalist, a family doctor and a partner. I do not regret my decision. The best part of my working day has always been the patient contact. And for the first time in my life I have held a job where I have come to know my colleagues and patients really well. For me that has been the charm of general practice.
But this has always come with the acceptance that we as GPs (and especially as partners) should provide the best level of care (that is timely and effective) for our patients and staff.
But the bigger picture has changed: the rules and goalposts that exist today in no way resemble anything from general practice of even a few years ago. Both primary and secondary care is now under unprecedented attack from a government which is a pro at the art of spin and not saying what it really means. Anything and everything that it spews out has to be taken with a tub of salt.
We are accused of overspending, fuelling our own demand, letting cancer standards slip, not following NICE guidelines and only providing in-hours care. We will probably be blamed next for being architects of our own burnout.
Is it any surprise that demand has gone through the roof? 9.1% of our GDP is spent on the healthcare (significantly less than is spent in Germany, the Netherlands, France, Sweden and Switzerland) and the UK has one of the lowest number of hospital beds (2.7 beds per 1000 patients) in Europe. We continue to see cuts to social care and closures of GP practices and other community services.
When my patient Elsie was admitted for delirium last week she came out of hospital 48 hours later – yes still in delirium. She had spent her in-patient stay mostly in the emergency department, then on a trolley in a corridor and finally as an outlier on a surgical ward, alongside countless other outliers.
Her family praised the hospital staff who were under huge pressure to facilitate discharges, create bed space and remove bottlenecks. It is perhaps no coincidence that another patient rang me today, understandably upset that his knee replacement operation was cancelled this week due to no bed availability.
So many of us - doctors, the BMA, patient groups and the public have highlighted their concerns about NHS funding. Even government health officials have voiced fears of the financial crisis that we are deeply embedded within.
Will this government listen? Or is it going to diffuse this time bomb with ‘accounting fixes’, secretive STPs and a pat on the back?
- Dr Aziz is a GP in Bristol