Are we the low lying fruit, an easy target for complaints? asks Derry GP Paul Molloy
Every day there are posts on Facebook about the local Casualty department being full. Inevitably the first comment underneath alludes to the “bloody GPs who won’t see anyone.”
There seems to be a belief that during and after COVID GPs downed tools.
To answer this: There was a serious workforce crisis in GP pre-COVID. The previous decade saw the collapse of most, if not all, single-handed rural practices. That was the start. This then progressed to larger rural practices. It largely went unnoticed as Derry and Belfast were unaffected. Then the problem hit those areas. So before COVID we already had a severe reduction in GP capacity in NI.
During COVID, GPs staffed, set up and ran the COVID centres while also still running their practices. Daytime GP changed to telephone triage to reduce face to face contact. During this time in the hospital, there was no elective surgery going on or out-patient clinics.
During COVID, many GPs retired and the practices that had adopted these new working methods had no option but to continue them due to an inability to recruit new doctors. These new methods facilitated the demand that still needed to be met by a reduced workforce. A reminder that General Practice in NI facilitates 200,000 consults per week!
Per week! Seeing patients is the most important part of our work but it’s only a part!
If you ask a young doctor what they think about GP in NI, their opinion is generally poor. “It’s far too busy”, “there is no respect for GPs.” A significant proportion of them leave every year for far off fields.
They want to be able to deliver quality appointments, 15 minutes long and to do this without the phone ringing or having three other tasks competing with that time.
The BMA along with younger GPs have worked out that 25 appointments per day per GP is the safe limit. This allows quality consults and protects the doctor also in the longer term from burnout.
NIGPC chair, Dr Frances O’Hagan clearly told Mr Nesbitt and Nolan (Show) that extra funding for primary care allows us to employ more staff and doctors. More doctors equals more access. Fewer doctors working safely equals less access.
I sat at my reception this am while my very experienced receptionists answered appointment requests. The first was redirected to the optician. The second was given an appointment with the GP. The third was directed to ED as it was an emergency. Each call takes time, perhaps 3-4 minutes. We have three receptionists answering in the morning. We are aware that while these calls are being addressed other people are trying to get through and pressing redial.
I’m sure if you press redial on a phone, it’s very likely that you could have 20/30 or more attempts before you get through.
They aren’t just ignoring the calls!
If you employ more staff access improves - simple.
Every single day I send letters (actually about 20% of my time) about patients on waiting lists for surgery or out-patients. I know from talking to retired consultants and new consultants that the average out-patient size clinic has reduced quite considerably over the past 20 years.
I actually agree with this. We should allow our Consultant colleagues the same time to deliver quality care and we should protect them from burnout.
However, every patient I see seems to simply accept there’s a long waiting list in hospital. There seems to be a reluctance to complain about hospital performance or more rightly political ineptitude over the years. Yet these very same people will complain that we (GPs) aren’t seeing anyone and they can’t get an appointment.
We have asked for funding to improve our service by employing more doctors and staff. We have been refused. Our access will suffer but we get the blame from the public. Are we the low lying fruit, that are an easy target for complaints? Has our access been too good in the past? Why do the public not support us? I can’t work it out.