Force Doctors to Work for the NHS

Exclusive report from Caroline Wheeler –  Political Editor at the Sunday Express.

Medical graduates will be forced to work for the NHS or repay the cost of their training under emergency plans being considered by the government to boost the number of GP’s.

Health experts say the Prime Minister’s pledge to make surgeries open seven days a week will be impossible to deliver without hiring thousands of doctors.

But with tens of thousands of GP’s on the brink of retirement and 5,000 a year thinking about leaving the UK, the Government is being forced to look at radical plans to boost numbers.

Proposals being considered by Primary Care Minister Lord Howe include making funding for medical training conditional on the doctor serving in the NHS for a set period of time to stop them moving abroad.

The minister made the claim as he was asked how the Government  intended to half the brain drain in general practice.

He told the Conservative Conference: “There are doctors who disappear to other countries quite soon after they train. That is drain on the system.

“Answers on a postcard as to what we could do about it. I suppose, one is to make the funding for medical training conditional on the doctor actually serving in the NHS for a given period of time. I don’t know what the British Medical Association would say about that. It’s quite a dramatic step to take in a free society.”

Earl Howe said the British military made its university funding conditional on graduates serving in the armed forces. “Maybe it should be thought about and I will take that point back with me,” he added. The Army offers a Medical Cadetship which pays tuition fees  for recruits and a salary of about £15,000 during the last three years of the course. In return they must serve in the Army for six years after training.

Last night the BMA said: ” We would be happy to talk to Lord Howe about the proposal but there is also a wider set of challenges facing the medical profession that needs addressing.

“We do have a problem recruiting and retaining GPs, as well as other specialists in secondary care, such as those who work in accident and emergency medicine. Last year more than 400 places at medical school  for trainee GPs went unfilled.

“Becoming a GP is still a very fulfilling career choice but because of the huge pressures being put on the service by the demands of an aging population and more elderly people coming out of hospital into the community services, it can be difficult to attract people to the career.” A national survey of final-year trainee GPs in August found one in eight intends to leave the UK within 12 months, with many expected to head for Australia with its shorter hours and better pay.

Last night the Royal College of General Practitioners urged the Government to look at financial incentives to train in general practice. It has called on the Government to pay off graduates student loans if they agree to train and practice in under-doctored or deprived areas.

Chairwoman Dr Maureen Baker said: “We have a severe crisis in general practice and our patients are already feeling the impact with longer waiting times to get a GP appointment.”

She added: “We need to seriously look at financial incentives to encourage medical graduates to train and then practise in areas that do not have  enough GPs.”

 You don’t have to be a doctor to know that general practice is in crisis. One in six patients now have to wait longer than a week to see their GP or nurse practitioner. Practices are closing their doors to new patients while forcing current ones to go elsewhere.

Family doctors have been left buckling under the strain, with growing numbers choosing to emigrate, retire early or change medical speciality.

The result has left Britain facing a GP recruitment crisis similar to the one that hit the teaching profession 15 years ago. Then, the government responded by offering “golden hellos” to teachers in priority subjects. Their student loans were also paid off by the state.

So how has David Cameron’s Government responded to this impending recruitment crisis? By saying everyone will have access to a GP every day of the week by 2020.

While the aims of this drive are laudable and will be cheered by patients (really
!) , the reality is that the existing service is already stretched to breaking point. So how will it cope with the promised seven-day-a-week service?

Health Secretary Jeremy Hunt has said 5,000 GPs will be recruited but the Royal College of General Practitioners claims an extra 8,000 will be needed by 2020 to meet even the existing demands.

With a national survey showing that one in eight final-year-trainee GPs plan to leave the UK in the next 12 months, the Government has to come up with a coherent plan to recruit, retain and return GPs to general practice. The issues regarding GPs will roll on and we can only hope with trepidation for  improvements to the service.

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