‘We are jeopardising the careers of a whole generation of new GPs’

Rebuild General Practice spokesperson Dr Carter Singh MBE on the concurrent unemployment and recruitment crises

It is no secret that there is a crisis in general practice. For over a decade, GPs have been ringing the alarm bells that something must change. Successive governments decided that the solution was recruitment – bolstering the number of GPs across the country in order to meet the rising patient demand. And while this is an essential cog in the wheel, it ignores the numerous other emergencies that practices are facing – which ironically includes an unemployment crisis.

Running a GP surgery, like running any small business, is expensive. Inflation and years of economic instability have hit surgeries hard. One of a surgery’s biggest expenditures is the cost of staff, and too many practices are having to make the difficult decision of not hiring additional GPs, despite the sustained rise in patient lists across the country. 

We are seeing this oxymoronic phenomenon across all areas of general practice. GP partners’ expenses are going up, including the hike in employers’ National Insurance Contributions, making it more difficult to offer competitive salaries for salaried GPs. This leads to fewer salaried roles, and more GPs choosing to take the route of being a locum. However, locums are also feeling the effects – with over half of locums finding fewer shifts now compared to two years ago. 

This crisis isn’t contained among the medical community, either – it’s spilling over into patient care. Patients are experiencing longer waiting times, despite having more trained GPs entering the workforce than ever before. Aside from the obvious inconvenience to patients, we know that longer waiting times lead to illnesses becoming acute and putting more pressure on secondary care.

With fewer GPs and growing patient lists we realistically have two options. The first is to reduce the number of appointments we can offer due to having an insufficient number of GPs to carry out care. The second is to try and keep up and see more and more GPs burn out and leave the profession. Neither of these options guarantees the quality care and continuity of care patients deserve. 

These concurrent crises are also risking the future of Britain’s medical workforce by jeopardising the careers of a whole generation of new GPs. Without the stability of a fairly paid, salaried job, how can we expect our young GPs to get their foot in the door? What incentive do they have to continue as a GP if there is no prospect for their future? We know that the family doctor model works for and is popular with patients, but a missing generation of GPs would put this into even more jeopardy. 

The Government has made steady progress in addressing the crisis in general practice. Towards the end of last year, the health secretary announced upwards of £800 million in funding for general practice. But coupled with the expected National Insurance rise, this funding won’t go far enough. Government must listen to GPs and ensure we have the adequate funding to hire and retain GPs and sustain funding at this level year-on-year. 

Without the Government ensuring that our workforce expanding translates into real, tangible changes for both patients and doctors, the spiral of chaos in the NHS will continue. Government must address financial barriers to hiring, to ensure GPs have surgeries to go to, and patients are receiving the quality, timely care they need and deserve.

Dr Carter Singh MBE is a GP in Nottinghamshire and Rebuild General Practice spokesperson.