Skip to main content

Should all GPs become NHS employees?

In a debate article in the BMJ, Laurence Buckman and I discuss the arguments for against GPs in England becoming NHS employees. Primary care in England’s NHS is in crisis. Recruitment of GPs is difficult throughout England, with many practices reporting vacant posts; many GPs are considering retiring early, and others want to cut down on their clinical work. The problems faced by GPs are partly due to the contracts that general practices have to provide NHS services and the way secondary care is organised. These contracts encourage the NHS to transfer work to primary care with the expectation that GPs will pick up this work at little or no extra cost. Most GPs would have no problem with taking on such work if they were given time to deal with it during their current working week. If GPs had employment contracts similar to NHS consultants they could have job plans, with time allocated for clinical work and for activities such as administration, teaching, training, and research.

Read the full article on the BMJ website.

Comments

Popular posts from this blog

What is the difference between primordial prevention and primary prevention?

Primordial prevention and primary prevention are both crucial strategies for promoting health, but they operate at different levels. Primordial prevention aims to address the root causes of health problems and improve the wider determinants of health. It focuses on preventing the emergence of risk factors in the first place by tackling the underlying social, economic, and environmental determinants of health. This involves broad, population-wide interventions such as: Policies that promote healthy food choices: Think about initiatives like taxing sugary drinks to discourage unhealthy consumption, or providing subsidies for fruits and vegetables to make them more accessible. Urban planning that prioritises well-being: This could include creating walkable neighborhoods with safe cycling routes, ensuring access to green spaces for recreation and relaxation, and designing communities that foster social connections. Social programs that address inequality: Initiatives aimed at reducing pov...

Talking to Patients About Weight-Loss Drugs

The use of weight-loss drugs such as GLP-1 receptor agonists (e.g., semaglutide, tirzepatide) has increased rapidly in recent years. These drugs can help some people achieve significant weight reduction, but they are not suitable for everyone and require careful counselling before starting treatment. By discussing benefits, risks, practicalities, and  uncertainties, clinicians can help patients make informed, realistic decisions about their treatment. Key points to discuss with patients 1. Indications and eligibility These drugs are usually licensed for adults with a specific BMI. They should be used alongside lifestyle interventions such as dietary change, increased physical activity, and behaviour modification. 2. Potential side effects – some can be serious Common adverse effects include nausea, vomiting, diarrhoea, and abdominal discomfort. Less common but more serious risks include gallstones, pancreatitis and visual problems. Patients should know what to watch for a...

Abolishing NHS England will make only modest savings

Abolishing NHS England and reducing Integrated Care Board (ICB) staffing by 50% may appear substantial, but the projected savings - around £500 million annually if fully achieved - would represent only a modest increase (approximately 0.25%) in annual NHS funding in England, given the NHS England budget is approaching £200 billion per year. Evidence from past NHS reforms (like the 2012 Health and Social Care Act) shows mixed results; some efficiency gains but often offset by new layers of complexity elsewhere in NHS structures. Without parallel initiatives to streamline administrative processes, improve efficiency, and enhance clinical productivity, such structural changes to NHS England and ICBs alone will not significantly improve frontline clinical care or health outcomes. Administrative costs, while important to minimise, make up a relatively small proportion of the overall NHS budget. Genuine productivity gains will therefore require systematic reforms aimed at reducing unnecessar...