“If you increase the age of the population by five years, the data suggests you need to roughly double the available health care,”
His practice’s NHS contract assumes about three and a half contacts with each patient each year; there are currently about seven annual contacts.
“When politicians stand up and make another promise that ‘your doctor will be legally obliged to see you in a week’ or whatever,” Hodges says, “They are either making a promise about my nonexistent time or this practice’s nonexistent money. They have no right to do either.”
When Hodges got his first salaried GP job there were 50 applicants. Today, all the local GPs I speak to insist that you could pretty much walk into any practice in the county and be hired on the spot. Not surprisingly, young doctors often prefer a few days a week as a contracted locum without the pressure of also being responsible – as here – for the management and livelihoods of 140 staff. The result is a kind of perfect storm of stress on the traditional partnership model – a recent Royal College of General Practitioners survey found that 42% of GPs in England were “likely or very likely to leave the profession in the next five years”, with nearly half of those suggesting burnout or stress as the prime reason.
“It’s the boiling frog analogy,” Hodges says. “The water’s not been comfortable for a decade, but it’s now very noticeably warmer. It will soon reach a threshold where there is a collapse.”
If all that sounds despairing, Hodges then opens his doors, as he does every working morning, to offer the everyday hope of consultation. Aspen has moved to 15-minute appointments (from the NHS regular 10), because it accepts “that most people will come with a list and it makes sense to look at everything”. I sit quietly in the corner and, with consent, observe that still sacred confessional between GP and patient. Looking on, it is hard not to see almost every case as a brief essay on the state of the nation.
If all that sounds despairing, Hodges then opens his doors, as he does every working morning, to offer the everyday hope of consultation. Aspen has moved to 15-minute appointments (from the NHS regular 10), because it accepts “that most people will come with a list and it makes sense to look at everything”. I sit quietly in the corner and, with consent, observe that still sacred confessional between GP and patient. Looking on, it is hard not to see almost every case as a brief essay on the state of the nation.
Large areas of childhood behaviour have been medicalised. Parents expect answers. “Classic mental health issues such as psychosis, bipolar disorder, that is probably 3 or 4% of the people we see,” the doctor says. “Everything else is related to external stress and anxiety.”
“In the past,” the doctor says of some of his lonelier and more troubled regulars, “they might have gone to see their vicar. Now they come to us.”
the original glue of the NHS – that comforting mythology of a family doctor.
Sun 27 Nov 2022 The Observer.
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25 Ιανουαρίου 2023, 21:01:53