Dr John Havard: Will the election result have a major impact on local health services?
- Credit: PA
The Government is promising seven day access by 2020 while Labour is promising 8,000 new GPs but it does seem neither aspiration has been thought through beyond the ballot box.
This current recruitment shortfall is being compounded by increasing numbers of trained GPs leaving the workforce, most significantly GPs approaching retirement, but perhaps more worryingly, women in their 30s. It really should be a burning imperative to facilitate women getting back to work after children. Retainers and returners should be the norm and not the occasional. The other reality to be tackled is junior doctors emigrating or having long stretches working abroad.
The cost of training a medical student is at least £250,000 so the country must make this investment wisely. We should be ensuring less students drop out, less emigrate and more work longer in the NHS. It is suggested a greater percentage of bright school leavers are dropping out than those entering at graduate level and one might surmise the graduates had thought more about the course independently than the school leavers being pushed by parents and schools. In 1996, 4% of successful applicants were 25 or over but by 2011 this figure increased to 24%. Graduate Entry Programmes were introduced in 2001 which provided a shortened four-year course and must have been a significant factor in stimulating the shift.
What could be done?
I would stop medical school entry before 21 to ensure greater commitment from students the country is investing in. I would also make the grant and maintenance fees an NHS loan which is free if the male student does 21 years working for the NHS and maybe women should have a year reduction for every child. If less years are served, I suggest a pro rata reduction but this loan would be real with the ‘get out of gaol’ promise once the NHS sentence had been served. Maybe this sounds like slavery but it seems fairer that graduates should be making balanced work/financial decisions rather than potential applicants being scared off by training costs. Of course the NHS can recognise jobs abroad as affiliated but the fundamental concept is to get doctors to realise just how much their country has invested in them and ‘paying’ this back through working for the NHS seems only fair. If you join the forces then in order to get the best training opportunities you sign a contract for up to 21 years. This makes the investment in training worthwhile and leaving early incurs a financial penalty - why should doctors be different when they cost us all so much more?
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How do we get more junior doctors to become GPs?
The medical school websites focus on teaching and research facilities and typically have bright operating lights and surgeons pictured. There never seems to be a suggestion that half of all graduates need to end up in General Practice to keep the NHS afloat.
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Retaining doctors and nurses in the workforce.
It should be a national imperative to get our doctors and nurses back to work after career breaks but we make it very hard. If a nurse wants to return after working less than 450 hours in three years and not having done 35 hours of academic study, she has to undergo retraining like being a student nurse again. The system does not place enough value on experience and means the national pool of working nurses is too small so we have to bring in nurses from abroad to cope with demand. Language problems often mean this solution is less than perfect.
What should be done?
A simpler and more welcoming attitude to encourage doctors and nurses back into work is a must-do since the country needs them.
What will be done?
Don’t hold your breath...