08/04/2024
Dr lan Harris, deputy chair of BMA Cymru Wales' GP committee, asks in Western Mail
how we can expect family doctors to be there for us when GP services have been gradually and systematically starved of funding
THE problems in general practice in Wales can be summed up in three words - workload, workforce and wellbeing
An increased workload, ageing population, surgery closures, rising rate of chronic illness and having to provide more complex care have created an overwhelming volume of work. While the demands on the service increase, the workforce has shrunk. We now treat more patients than ever before, with an average rise in patients of 23% per GP thanks to the closure of 94 practices and a 21% decline in full-time GPs.
Inevitably, GPs' wellbeing has suffered, and sadly we've seen a rise in mental health issues, with many leaving the profession they love.
Last year BMA Cymru Wales launched the Save Our Surgeries campaign, in which we called on the Welsh Government to:
• commit to adequate funding of general practice, restoring the proportion of the NHS Wales budget spent directly on practices; invest in the GP workforce, allowing us to maintain safe and high-quality services; produce a workforce strategy to ensure that Wales trains, recruits, and retains its GPs; and develop a long-term strategy to improve staff wellbeing.
Despite acknowledgment of these issues by the Welsh Government and NHS Wales, little has been done to address them. Public support is strong, with over 21,500 signatures on a petition for better GP resourcing. Yet the percentage of NHS Wales spending on GP services has dropped significantly.
How can we expect family doctors to be there for us when they ve been gradually and systematically starved of funding for so long?
I've seen this in my own practice. In 2001 we had 14,000 patients; we now have more than 18,000 patients but the same number of full-time equivalent GPs.
Last year, 20 million appointments were held at GP surgeries in Wales. Many colleagues have gone part-time to cope with the rigours of the job - working full weeks of
12-hour days making potentially life-and-death decisions takes its toll.
Patients tell us they are pleased with the care they receive, but they are waiting longer to see us as we don't have enough GPs and staff to see them. Access problems and waiting times are a consequence of a system where capacity cannot meet demand, hurting morale and wellbeing. The patients aren't getting the care as quickly as they deserve.
Increasing numbers of GPs are leaving the profession. Locum GPs can't find work because there are no funds to employ them.
Private GP services are popping up across
Wales, while NHS practices worry about surviving the next year with rising costs. Local health boards are being bailed out by the Welsh Government, while GP surgeries receive real-terms funding cuts and have more work passed to them by hospitals as waiting lists spiral.
Surgeries in Wales are heading for the cliff edge and fast. Without immediate action to reverse funding cuts, the future of GP services in Wales is bleak.
Ian Harris British Medical Association
