Roger Goss, Radio 5 live, 7 10 am, 13/11/13.
“The real strategy you need here is to make primary care effective. It’s outrageous that so many surgeries operate on the basis of ordinary office hours. And even worse, because about half of GPs are women, they only want to work Monday and Wednesday afternoons, and having been paid for at the tax-payers expense in many cases, they really ought to be required a minimum number of hours a week. …
“What is the evidence that women doctors only want to work on Monday and Wednesday afternoons?”
“The evidence is all the people who call us on our helpline, or email us, and tell us they can’t get an appointment, can never see their own doctor, because they’re only there a couple of days a week.”
“So you don’t believe that any doctors, women or otherwise, should work part time?”
“No, I think they should work a minimum number of hours a week but some of them work very few at all. As people have said, the reason that A+E gets clogged up is because people are told to ring up at 8am to try and get an appointment at the GP surgery and are told they can have one in 2 weeks time and they can’t wait…”
“Would it not concern you that if you limited flexible working that might cause even more of a staffing crisis in not just our GP surgery but potentially hospitals as well?”
“No, I’m not aware that people no longer want to become doctors, it’s a very attractive career, what surprises me is the difficulty in getting doctors to work in A+E..”
SORRY ROGER. Let’s talk.
-Primary care is effective. We have appointments from 7.30 am and our building closes at 6pm. It’s 6.30pm in most of England. If some one phones in and tells us that it’s urgent, we will see them that morning or afternoon. In the evenings and night times, GPs like me are are still WORKING – but from a safer, more organised, central base like GEMS in Glasgow. GPs set up great out of hours centres because covering your own practice at night was unsustainable and dangerous. Read this.
– I’m a woman doctor. A WOMAN. Gosh. I worked horrible shifts as a junior, with a 1 in 3, and I found it unsustainable in terms of exhaustion. I was paid a third of the usual hourly rate for the on calls. I paid the taxpayer back pretty handsomely in my junior doctors years alone. So seriously, don’t worry about what I owe the taxpayer. I’ve paid it back. But it’s interesting that LAWYERS and ARTS STUDENTS don’t get the same accusations thrown at them. And if you want to argue about where NHS training goes, you would better to look at the whole PRIVATE MEDICINE sector.
-Still, as a woman doctor, I had babies. Amazing! This happens, it’s fairly well known. Anyway, I had some MATERNITY LEAVE. Then I went – gosh! – back to work. I work five sessions a week in the practice. This actually works out at about 30 hours, and then I have all my professional learning to do as well, meetings about our local services and teams, which easily takes me up to the normal full time working weekly hours of the nation. And I’m ‘part time’. IS THAT ENOUGH? Oh, yes, and then I teach students one afternoon. SORRY ROGER – yes, I could be seeing patients during that time. AM I MORALLY INFERIOR? But I think my patients will benefit from knowing that they will have well trained doctors after I’m dead. Which, with the amount of stress that GPs are under to provide instant appointments and dementia screening and healthcheck results reviews, might be quite soon.
-IT IS TRUE that I am at work on Monday and Wednesday afternoons, but ALSO some other times as well. These days are usually no-toilet days, in that quite often I am aware that the reason for my lower abdominal pain at 6pm is that I have been so busy that there has been no time for the loo. MAYBE it’s my fault though – maybe I just didn’t start early enough? Sorry, Roger.
-Men doctors. THEY WORK PART TIME TOO! Except they don’t get the stigma. So all these GPs on Commissioning Boards, all these men who have management roles or committees or whatever – they somehow escape the HORROR of being a PART TIME doctor because they are not FEMALE. Let’s out myself – yes- I am a PART TIME FEMALE DOCTOR WHO HAS HAD BABIES. Wheew. I have come across academics and medical politicians – even PROFESSOR STEVE FIELD HIMSELF – who works ONE session a week. Are you going to criticise him too? Let me know.
Let’s talk about what the real problem is.
– APPOINTMENTS . GP surgeries used to organise their own ways. Then Blair said you must have 48hour access. This was a disaster. Surgeries set up for 48hour access alone. This was nonsense and stupid.
Let GPs, with their patients, sort out the best way to organise appointment systems. I don’t think this will ever be perfect. But it could be better. At the least, it needs to be flexible enough for the individual community.
-WHAT APPOINTMENTS ARE BEING USED FOR. The GP contract has created ‘need’ for zillions of appointments for people who don’t really need them. These are the forms of chronic disease monitoring, which the contract requires. The GP contract effectively priorities the well (people who have stable disease and who book ahead for appointments which often aren’t necessary) over the sick (people who have symptoms or who are ill and want to see a doctor that day.)
-SEXISM. Lots of doctors work part time for very good reason. Frankly, the job is so intense, stressful and demanding that I feel safe to predict that newly qualified GPs, men and women, will be looking for part time, not full time GP jobs. We could make that stress lighter, that job easier to do, if we had patient reps who wanted to work with GPs, and be on the same side, rather than belittling us just because we are female. The hostility from people like Roger is a reason why GPs will leave, and a demoralised, depleted workforce is AMAZINGLY not good for patient care at all.