True ‘faithful’ Copperfield reflects on our recruitment/unemployment series, searching for the traitors within general practice
I’m suffering from Traitors’ withdrawal syndrome. How I miss the backstabbing, the cod psychology and the contestants’ odd inability to say the word, ‘You’ (‘I voted for yourself, Freddie. Sorry.’)
That said, there’s some consolation to be found in the General Practice Workforce White Paper which sets out to explain the paradox that we’re simultaneously suffering recruitment and unemployment crises.
Because some see traitors within. As in, business-savvy partners way more invested in the health of their bank balance than that of the practice population, who exploit ARRS staff as a source of cheap stopgaps rather than taking on proper GPs currently stacking shelves. They are manipulative, exploitative and spoil it for the rest of us, goes the narrative. We should vote themselves off.
Well, as a faithful (honest, no, really, I swear, as one GP to another), I think I should point out that it was ever thus. There have always been entrepreneurial and financially motivated GPs keen to make the most of the cards dealt them by the prevailing Government (anyone old enough to remember GP Fundholding?). But they’re a tiny minority. The truth is that chronic underfunding means most partners have to take what they can, not to make a fortune but simply to get through the day.
And even then it’s not enough to prevent job losses. As an ex-partner and now salaried, I’ve sat on both sides of the divide. And just in case you’re wondering, I can reassure you that being a partner involves crushingly stupid levels of stress, workload and jeopardy. Most are so utterly knackered that there’s simply no energy left for devious financial strategizing, even if they’re that way inclined.
The real traitor here is the previous Government. It quite possibly engineered a scenario where core general practice has been irreversibly degraded to a noctor-led shambles, leaving the few remaining GPs to default to a stultifying and crucifying role of preventing all illness and admissions. And just because I sound like a conspiracy theorist doesn’t mean I’m not right.
So, it seems apt that the crack cocaine of Traitors is being replaced by the watered-down methadone of The Apprentice. ‘Traditional General Practice, you’re fired!’ I’d like to thank yourself, Sir Alan, for the opportunity.
Dr Tony Copperfield is a GP in Essex
From the beginning ARRS staff were taking away from core GP. They were funded below the reimbursement level, once in place it was clear they increased workload as well as taking from the budget. So many didn’t do their sums and accepted at face value ‘free staff’. The opportunity costs of these staff are very high for negative return in many cases. Even when they work really hard to help patients their costs are increased not reduced.
You joker….just a tiny minority of rotting apples, the rest in the barrel are good, so all’s well. A bit like:
“It’s just a tiny hole in the hull, Cap’n, wot the iceberg made. The rest of the ship’s okay, we’ll be fine.” Atlantic ocean 1912
“The tiny whatsit on top of the doodah was a bit loose, Chief Engineer, but the rest of Columbia was okay. Re-entry will be fine.” Texas 2003
“Don’t worry Mr Scrote, trust me I’m your GP, it’s just a tiny sticky-out bit on your testicle, try this cream. The rest of you’s fine.” Essex 2024
Though invisible in sunny Essex, this tiny minority, in other cities, is in-your-face like the swollen bottom of an angry baboon twerking on your windscreen at Windsor safari. And why is this tiny minority nearly always men??
Oh and the trouble with sitting on both sides of the divide is it’s sore on the arras…and it was the arras wot did for Polonius.
TC nails it once again
The current model is broken. We should adopt the Australian model. Payment per item of service. It seems a lot of UK GPs are increasingly adopting it already. They can’t all be wrong.