The overworked staff are abandoning the system in search of more money, flexibility and resources.
GP practices are under increasing financial pressure and are struggling to maintain clinical excellence whilst under such economic strain.
This comes as Healthwatch England reports a significant increase in patients paying for treatment, tiring of the long waiting lists.
Vijay Acharya, a leading healthcare policy analyst, revealed: “Rising staffing costs, pension and national insurance contributions, estates pressures, inflation and increased administrative demands are piling financial pressure onto GP practices. The system expects GPs to deliver clinical excellence while simultaneously running what are, in practice, small businesses, often without dedicated financial training.
“The time partners can devote to understanding accounts, funding flows and longer-term planning is incredibly limited.
“In turn, the practices cannot pay their staff a suitable wage and the recruitment of highly qualified individuals is too expensive.
“They end up letting go of the highest paid practitioners, as a financial move. These individuals are now setting up private practices to obtain a better work environment.”
Mr Acharya surveyed the 350 GP practices he looks after and reported that just under 50% are under financial strain and 15% face closure.
Dr. Amun Kalia has set up a private GP and specialist practice, The Barnes Doctors, to provide better care for his patients in SW London.
The 39-year-old Londoner, who also helps to run an occupational health business, revealed: “Medical training has always been tough, but I really enjoyed my GP years. I enjoyed the continuity of care, looking after babies to adults, all family members. I enjoyed being the family doctor.
“However, as I have progressed through my career, that has degraded over time. The old-fashioned family doctor doesn’t really exist anymore. It has become a transactional fire-fighting service, where you have potentially unlimited demand from patients and limited resources to provide best practice care.
“This became frustrating as I saw the reality of general practice compared to what the textbooks taught us was best practice.
“In my opinion, in the NHS, the biggest challenge is the lack of time. You haven’t got the time to be able to do your job properly.
“Medicine has also become more complex over the years. We have gone from multiple ailments to treating potentially thousands. We are also treating them at complex levels. Coupling this, there is a continued pressure to keep patients out of hospitals, which are also stretched- further compounding pressures on NHS GP services.
There remain clear pressures and challenges in accessing healthcare services however GPs carry out 90% of the consultations in the NHS and are actually far more accessible than hospital consultants due to the number of us but even then a 2-3 week wait to see an NHS GP is not unheard of.
At private practices like The Barnes Doctors, patients can access appointments immediately and restore the personal rapport between GPs and patients, which in my opinion, is diminishing through the NHS.
Dr Kalia added: “My patients can access care immediately. We have in-house specialist consultants who they can have appointments with weekly – adult psychiatrists, child and adolescent psychiatrists and gynaecologists.
“Patients can walk in and get an appointment on that day. If they want to see a particular doctor, they may have to wait a matter of days rather than weeks.
“We provide face-to-face, 30-minute appointments as standard. In NHS practices, you are lucky to get a 10-minute appointment or a 5-minute phone call due to costs and demand constraints. This makes it very hard to provide good quality, holistic care.
“We charge £160 for a half an hour appointment with a doctor of your choice. We remove the barriers to access – you can book online, call, email or walk in. The reality is, by charging, I can retain good doctors, allowing them to do their job properly and keep the job rewarding as well as provide the best care for our patients who leave happy.
“In my opinion, the NHS is treated like a political football. The parties want to play with it, get votes and then send it over to someone else to deal with. I feel they lack real long-term vision or plans.
“The current system in my opinion is unsustainable. There is not enough funding in the world to fix it now. My patients want choice, and they will pay for access to good quality care. I believe we are slowly transitioning into the dentistry model of healthcare.
“In my opinion Primary care is moving towards a more privatised model allowing patients choice.
“I believe that government needs to focus on how they better help those who cannot afford private services.
“My patients have the funds to be able to be looked after properly. However, we do not want to see a disparity between the rich and the poor or create a social divide where the wealthy get healthier. It is a vicious cycle that must be broken.
“It is a cynical view to say that private GP practices are just focusing on getting the rich healthy. Instead, we are removing those who choose to access private services from a stretched NHS system – they can choose and afford to pay for healthcare. In turn, the NHS can have more resources for those who as less likely to afford private healthcare. In addition it’s a misconception that all our patients are wealthy. Lots of my patients save up to see us, come with multiple problems and I try my best to help them and assist them in navigating a complicated healthcare ecosystem working with the health service.
“The best model of healthcare I have seen was in Australia where, if you earn over a set amount, you can fully opt out of the public health service. You have a gold plated private policy which covers everything and is partially subsidised by the government. Those who earn less than the threshold have really good access to the non-private, state funded health service, which also covers everything. The best of both worlds.
“Whereas in England the difference in quality between most private and non-private practices is stark, Australia’s practices are indistinguishable.”
Vijay Acharya, whose firm has supported GP practices since the inception of the NHS in 1948, is a healthcare policy analyst and former NHS manager. He has been the proprietor of Charles Rippin and Turner (CRT) for 24 years. CRT has looked after clients in the healthcare sector for more than 80 years, taking a more personalised approach.
