When NHS waiting times are too long, the answer for many who can afford it is to ‘go private’. In the case of primary care, record numbers of patients are making that choice. In fact, so many people are opting to pay for private GPs that providers are struggling to cope with the demand.
Last year, half a million additional people took private health insurance, and although they are effectively paying twice for access to a GP, some are finding that their experience is largely the same. They are still facing long waits and the frustration of not receiving care when they want it.
Whiles some people see the private sector as an easy answer, that can’t always be the case. Even those willing and able to pay for private care can’t get it if there aren’t enough GPs, and that shortage is the root of the crisis.
The reality of the GP shortage
According to the BMA:
- For every 10,000 people, England has 7.8 GPs
- The OECD average is 10.8 GPs per 10,000 — to reach that level, we need 16,700 extra GPs
- One GP is now on average responsible for 2,304 patients (366 more than the 2015 average)
- Despite the government plan to recruit 6,000 extra GPs by 2024, full-time equivalent GP numbers are down by 2,212 compared to 2015
Whether it’s the NHS or a private business providing the primary care, they can’t provide what they don’t have — and they don’t have enough GPs.
When people imagine private care, they tend to think of it as a more efficient version of the NHS, with fewer patients and more capacity per doctor. However, if the private sector becomes flooded with new patients, the advantages of paying privately quickly disappear.
The roots of the GP shortage
The staffing crisis is a complex issue, and it would be unfair to say just one thing could solve it, but we do need to address the fact that a GP career is not attractive enough.
Our 2022 Primary Care Survey found that 99% of GPs feel overworked, and 94% are experiencing mental health challenges as a result. The BMA found that 67% say they have witnessed violence or abuse from patients.
Meanwhile, the media paints a picture of a workshy and neglectful primary care workforce, implying (or even stating) that waiting lists and patient demand would be solved if only GPs were more diligent.
In that context, it’s no surprise that GPs are leaving the profession (or the country), or that students might be put off the career, believing that becoming a GP means ten years of study and mountains of debt just to be overworked, abused, and scapegoated.
How to resolve the GP Shortage
The private sector is a useful supplement to the NHS, and it may relieve some burden on GPs, but it cannot handle mass adoption, and it is not immune to the same GP shortages that the National Health Service faces.
Solving the staffing crisis is largely about making General Practice a more attractive job.
Better pay is always one element. The NHS is out-competed by other health services like Australia’s, which is why many GPs are tempted out of the country.
Pay rises are admittedly expensive, and politically difficult to achieve, but one measure is absolutely free, and that is for the NHS and for politicians to vocally and publicly support GPs. You would surely keep some GPs from leaving, and discourage fewer from joining, simply by giving them more credit and less blame.
Thirdly, NHS England could stop imposing contracts that ignore the reality of primary care and the concerns of the people who work in it. They only further demoralise GPs and push them out of practice.
Skilled Worker Visas — low-hanging fruit
First and foremost, we need to address how we treat our GPs. However, we could immediately improve GP numbers by making it easier for NHS-trained international GPs to live and work in the UK.
Currently, a doctor from overseas who receives their Certificate of Completion of Training immediately loses their student visa. They then have to find a practice to sponsor a Skilled Worker Visa (only 20% of practices can do that) or they have to leave the country.
Nearly half of GP trainees are from overseas. Making it easy for an NHS-trained international GP to stay in the UK could effectively double our available GP workforce.
Better recruitment and retention for England’s GPs
While advocating for those very urgent reforms, MCG Healthcare is dedicated to matching GPs with practices, so that doctors can enjoy fruitful and fulfilling careers, and surgeries can have the skills that they need to deliver the best outcomes for patients.
If you’re a GP looking for your next salaried, partner, or locum role, or a practice hoping to fill a vacancy, call 0330 024 1345 or email hello@mcghealthcare.co.uk.
