Nowhere else to turn

The impact of austerity and proliferation of low paid insecure work is so bad that people are booking GP appointments to get help with issues such as housing because they have nowhere else to turn, Doctors in Unite has warned.

Doctors in Unite chair Dr Jackie Applebee told UniteLive that she regularly sees people who have booked an appointment at her surgery to ask for help with housing issues because they have nowhere else to turn.

She said that cuts are combining with a record drop in doctor numbers, an increase in responsibilities and rising patient demand to create a crisis in the nation’s GP surgeries.

Dr Applebee made the comments in response to figures released yesterday (8 May) that revealed GP numbers have fallen to their lowest level in half a century.

Nuffield Trust analysis for the BBC shows that in 2018 there were 60 GPs for every 100,000 people – down from nearly 65 in 2014 and the lowest level since the late 1960s.

Meanwhile a separate survey found that on average GPs are seeing 41 patients a day each, with ten percent seeing up to 60 – even though the limit for safe practice is 30.

Dr Applebee said, “More services are being cut so people have nowhere to go for advice so they come to the GP with things they would never have come to us with before because we can be accessed quite easily. People come to me with housing problems all the time.

“People come with stress at work, because people aren’t in trade unions these days. Zero hour contracts and all of that stuff means that people are being bullied at work and people don’t get paid when they’re off sick so they try to go in when they’re ill and make it even worse. It’s shocking really and all that impacts on our workload.”

Compounding the issue is that fact that GPs are expected to do more than ever with much less, explained Dr Applebee.

She said, “When I became a GP in the early 90s it was a simpler job than it is today. Everything could come through the door, but we weren’t doing the chronic disease management, mental health and (other work) then that we’re doing now.

“We’re doing all the stuff we used to do and we’re doing more. Previously general physicians would have to cover a lot of this work in hospitals but of course they’re gone now.

“That means that patients can’t get a GP appointment in a timely fashion and because of the extra workload people are burning out and leaving. Young doctors are thinking ‘I don’t want any of that I’m going to do something else’. It’s just a downward spiral.”

Dr Applebee said GPs, as well as other NHS and social care services, need extra resources.

She added, “There needs to be more medical school places and they need to be filled by people from much more diverse backgrounds. There’s lots and lots of kids from families who can’t even begin to think of £9,000 plus for five years who would be very very good doctors – that needs to change.

“However new doctors are not going to feed through in time to avert this crisis. At the moment we need to be encouraging people to re-enter the profession – lots of people are retiring early and they need to be encouraged to stay and it needs to be worth their while to stay.

“We also need to encourage more medical students to go into general practice. At the moment it’s seen as an area that the clever doctors don’t go into and that whole culture needs to change. And we need to have more junior doctor placements in general practise too.”