Below are the notes from a public meeting held in Bolton to discuss the situation around local GPs following a take over by the private health company Operose.
1st speaker was Jacqui Wakefield, a Panorama presenter. The private company Operose, which is owned by the US health insurance company Centene, itself owns 70 GP practices and its focus is on profit. An undercover 2 month survey revealed that many GPs are stressed out, partly because their time with patients has been cut and partly because many of them are locums on a rota which doesn’t allow them to develop a relationship with patients or to get advice from an experienced GP who does know the patients. Some GPs are being replaced with other professionals whose training level is somewhere between that of a nurse and a GP, and there have been times when patients with chronic conditions have been sent to another practice so that Operas can make more money from lighter problems.
2nd speaker was Prof Ismail, Emeritus Professor of general practice at Manchester University and who has worked at an inner city practice
The model is changing for the worse`: companies say they can solve the problems, but cuts are leading to people getting 3rd class care and demand is rising as people are living longer. The primary care budget has been cut by 30% and if primary care fails, the system fails – 80% of problems are dealt with by GPs and this costs £175 per patient per year. A & E visits cost £250 and an ambulance £330. Because there are now fewer GPs and many are working part time because of stress, people are turning to A & E or dialling 111 for an ambulance.
What might help: change the number of doctors on call for prime days
Train reception staff better and get doctors to call back
Train nurses to become nurse practitioners
Employ a mental health worker, a physio, a pharmacist, social prescribers etc
A lot of GP practices are not designed to deal with the level of calls they receive and we need to change systems to cope with increased demand, but there is a danger that the government will demand longer hours without funding. We need to go back to a system where the GP is the first port of call and the overall system is much better integrated.
Care must be preventative, more joined up, more accessible and more personal. GPs should be allowed to get to know their patients.