Changes in General Practice

Is it the beginning of the demise ?
10 June 2008

kamal Sidhu, General Practitioner Sunderland
Send response to journal: Re: Is it the beginning of the demise ?
A debate on the most of the issues raised by the authors is the need of the hour.Whereas, the politicians are eager to be seen to be doing something with NHS, the medical profession stands disunited and disgruntled.
Within the last three years since I joined General Practice, its face has changed beyond recognition. Continuity of care is no longer a priority.'Cradle to grave' attitude has given way to one-stop service with the rather forced idea of polyclinics.
Miscalculations on behalf of government that resulted in significant pay rises for GPs are apparently being compensated by back door initiatives like extended hours in form of 'less damaging option A'.
Pace of the change is too fast resulting in all time low morale of the front line staff. Negative media spin about 'massive' rise in GP earnings coupled with problems with patient access had already pushed the GPs against the wall.Of course, it was the ideal time for the government to bring in its agenda of extended opening hours on its own terms, the threat of private care providers and Darji Polyclinics(even if evidence backs the contrary)
Job prospects for newly qualified GPs have dwindled and with hardly any partnerships available which is another issue the profession needs to debate amongst itself. While most will agree that patient access needs to be improved and some of the services can be moved closer to patient home,Is this the right way forward.There is a clear conflict between patient, doctor and Government agenda. Can a disheartened and disappointed GP provide quality care? Do the patients want any of the drastic changes being forced upon the profession? What is the long term future of NHS and its backbone, the primary care? Are we moving away from a health system which provides guaranteed health care to a system which is more consumer driven and a profit making organisation?
Only time will provide all the answers but one thing is for certain that if remedial steps are not taken soon,it may well be the beginning of demise of NHS.
Competing interests: I am a newly qualified GP.