NHS: Desperate Bonus of £20,000 for GPs

Young mother Kay Charnley’s local surgery is due to close and she doesn’t know which family doctor she will see in the future.

the very least, it will mean a car drive and a struggle to find a parking space instead of the short walk she takes now to the Woodingdean Ridgeway medical centre on the eastern edge of Brighton.

For Victor Neale, the prospect is daunting. The Woodingdean Ridgeway practice is just across the road from home for the 83-year-old and his wife, who underwent heart surgery recently. They face a bus ride or a long walk up a hill to another practice.

Woodingdean’s Ridgeway practice will be the eighth GP practice in Brighton and Hove to close since 2015. The local health watchdog estimates that up to a quarter of the city’s surgeries have shut in that time, forcing more than 33,500 patients to change GPs.

The situation in Brighton is not unusual, as 38 GP practices closed or merged in London alone last year. NHS Digital figures show that 202 GP practices closed or were absorbed by other practices in the year to 2017, with 64 in the north of England, 54 in the south and 46 in the Midlands and East.

According to the British Medical Association the number of surgery closures is a particular issue in less well-off rural and coastal areas, such as Lincolnshire, Essex and the south-east coast. Now Health Secretary Jeremy Hunt is to introduce a package to try and alleviate the problem by offering a “golden hello” bonus of £20,000 to GPs in training if they start their careers in the hard-hit countryside or on the coast. The bonus idea is a desperate bid to boost numbers of family doctors in areas with recruiting difficulty.

Not A Solution

But is it enough, or is it just “short-term window dressing” for what has been described as a GP crisis? Hunt has told the Royal College of GPs that he will commit  £4m to the bonus scheme, which translates to just 200 doctors. Spreading that many GPs around the country will barely represent a sticking plaster solution in hard-hit areas such as Brighton.

The Royal College of GPs has given a half-hearted welcome to Hunt’s package, pointing out that NHS England has already pledged to fund an extra 5,000 GPs by 2020 – just over two years away. Dr Richard Vautrey, chairman of the BMA’s committee on GPs said the Government was not on course to reach that target. “General practice is facing unprecedented pressure from rising workloads, stagnating budgets and a workforce crisis,” he said.

“Golden hellos are not a new idea and unlikely to solve the overall workforce crisis given we are failing badly to train enough GPs to meet current demands.”

The Nuffield Trust think-tank said recruitment was only “half the battle.” Senior policy fellow Rebecca Rosen said the NHS is “struggling to hang on to qualified GPs with surveys showing 56% plan to retire or leave practice early.” The staff shortage was exacerbated by the fact that workplace stresses had reached the point that ”many trainees also drop out when they finish,” she said.

Any doctor who takes up the £20,000 offer but later moves away from the area they have accepted before ending the three-year training programme would have to pay back part of the money, the Health Secretary said. He also confirmed plans for a large-scale overseas recruitment office to try and lure GPs from countries outside Europe – particularly Australia – to come and work in the UK.

The various recruitment schemes can hardly help Kay Charnley. “It’s like starting all over again after 18 years at the surgery,” she said. Her two children were born with prenatal advice at the Woodingdean surgery. “The doctor at my old surgery was really good on women’s health. It really counted during my pregnancies. Now I’m not sure who I will see.”

 

by Bob Graham

 

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