Dr Burnt Out takes a satirical look at what 2025 could have in store for general practice
January
North West London ICB suddenly halts funding to half of the area’s GP practices, and announces that they need to all urgently move to an empty repurposed storage warehouse along the edge of the North Circular Road which has been fitted with flat-pack IKEA desks and scrapped computer monitors.
The GPs are given instructions on how to assemble their desks and computers on arrival. They are to share the building with a new NHS profession called the ‘integrators,’ although the integrators are even unsure about what they need to integrate. The integrators turn out to be unemployed PAs who have done a half-hour e-learning module: ‘How to move from analogue to digital in the NHS.’
February
Wes Streeting, Alan Milburn, and Sir Keir Starmer are spotted having dinner with a deeply orange Tony Blair in the newly reopened Granita restaurant in Islington. An undercover journalist overhears Blair saying: ‘We need to take a leaf out of The Donald’s playbook – look what he’s planned to do with the US health system – the profits are astronomical… Elon wants us all to go to the meeting with Amanda about the NHS AI installations next week…’
This is all over the media the next day, and The Guardian headline is: ‘Blair, Musk and the new NHS Granita AI pact 30 years on…’
March
It is leaked to the media that Starmer has reportedly said ‘GPs are finally getting what they deserve’. Another source close to the Prime Minister claims he holds a grudge against GPs ever since he was mistakenly prescribed Proctosedyl ointment instead of Rectogesic ointment by a locum GP in 2007.
Labour launches an independent investigation into the repeated leaks from DHSC.
April
In the new RCGP assisted-dying survey, 61% of voting GPs say they are in favour of assisted dying and so the official position of the RCGP is now ‘in favour’ of assisted dying. A spokesperson from a disability and elderly care charity is quoted raising ‘concern’ and ‘surprise’ to find out that most GPs would be in favour of them popping their clogs.
May
Wes Streeting announces ‘ground-breaking’ investment into general practice and primary care. The figures look impressive and the left-wing media lap it up as ‘unparalleled investment into general practice.’ It is not mentioned to anyone at any stage that the amounts stated do not cover even half of the extra NI contributions that practices must pay.
June
Lord Darzi is announced as the new minister responsible for general practice. Stephen Kinnock MP has been moved to a new department in The Ministry of Health: The Department for the Timetabling, Health economics analysis and Review of Assisted Deaths, known as DETHERAD which he is now heading up with Lord Falconer.
July
We reach full-fledged industrial action, almost a year after collective action began. There are mass picket lines outside closed surgeries with GPs wearing orange BMA t-shirts emblazoned with the slogan ‘GPs are on your side’. Badges are given out to patients walking past the surgery.
It makes it onto the front page of the Daily Mail when one GP is pelted with a salted caramel Frappuccino from Starbucks by a disgruntled patient who could not get their Tramadol prescription.
August
It is a quiet month for general practice.
Meanwhile, a disabled elderly man living on his own is found dead in his flat in Bristol, phone in hand. It is later established that on the day he died he had made 43 attempts to submit an e-consultation without success. He lived just across the road from his GP surgery.
September
At the BMA, GP partners, salaried and locum GPs agree that everyone is in dire straits, and that they all need to join forces to try and save the profession.
They agree on a march of ‘unity’ of the profession for early December, starting at the RCGP headquarters and marching to BMA house. They encourage all GPs (partner, locum, salaried, retainer, registrar, academic and any other ilk) to join together in this final demonstration of ultimate collective action.
October
Many GP practices are on the brink of bankruptcy – indeed some have already gone under. Salaried GPs are being made redundant and not having their contracts extended. There is one locum session available in the whole of Manchester for the entire month, which has 2,356 applicants.
November
Keir Starmer re-iterates in the House of Commons that he would never – in any circumstances – ever use private medical treatment. Not even if his or his family’s lives depended on it. He adds that when he was growing up, he and his working-class family (tool-maker father included), did not even know private doctors existed; and so he will do everything in his power to ‘save the NHS.’
Cue eye-rolling from Streeting.
December
Over 40,000 GPs gather outside RCGP HQ. It is freezing and snow has begun to fall. They slowly walk down Euston Road, and then turn right down Upper Woburn Place heading towards BMA House, singing ‘Keir, Keir, Kier; Out, Out, Out!’
Starmer, Streeting and Lord Darzi are all in BMA House having last-ditch talks with BMA and RCGP leaders to try and come up with a solution.
Just as the march reaches the door of BMA house in Tavistock Square, a deal is struck and there are smiles and handshakes all around. Starmer, Streeting and Lord Darzi emerge outside of BMA house’s front courtyard. A microphone is hastily brought out to them as the crowds bay.
‘This is a historic day’ announces Streeting. ‘We have reached a deal with the RCGP and BMA which will mean an end to GP unemployment, all the GP liabilities will be written off, and we make a guarantee that every full-time GP will earn at least the same as a full-time hospital consultant.’
There is silence and then a small ripple of applause starts, quickly spreading across the whole crowd. A GP in the crowd who had huge personal liabilities, throws a Five Guys strawberry milkshake up in the air in celebration. It splatters over Starmer, Streeting and Darzi.
The trio look at each other and simultaneously, out of everyone else’s earshot, whisper ‘I f**king hate GPs’ to each other, after which they turn back to the crowd smiling.
Dr Burnt Out is a GP locum in London
