Dr Phil Hammond, GP and atheist presenter of BBC1's Heaven and Earth Show

Hey ho. Only GPs could stage a national day of protest that clashed with the anti-capitalist marches and National Carpet Day.

But the rather limited publicity for our 'crisis of morale' may have had more to do with the fact that not many people took part.

Aside from that communist hotbed Weston Super Where?, action was limited to three GPs waving a damp placard outside the Department of Health and a sporadic outbreak of long lunch-breaks to catch up on paperwork. Alan Milburn must surely have been quaking.

So, just to cheer you up, here are some more reasons why a GP's lot is going to get worse in the next year.

The Shipman Inquiry

Dr S has already put terminal care back into the Dark Ages by frightening doctors and patients away from adequate doses of morphine. But this private-turned-public inquiry is going to be hell for the poor GPs who signed the second part of his numerous cremation forms. Having had 6 hours on the stand at the Bristol Inquiry, I know how rigorous cross-examination can be.

My experience of signing Part 2s is that a colleague in a neighbouring practice phones you up, tells you someone's died of natural causes and everything's tickety-boo.

So you thank him profusely and pop down to the undertakers to sign for your money. On a good day, you might even whip back the sheet as far as the face or check the toe-tag.

I'm not sure if we're legally bound to examine the body for anything more suspicious than a retained pace-maker, but you can be sure that any barrister worth his salt will have a field day with this rather laissez-faire approach.

Expect more 'Greedy GPs fail to spot murder' headlines.

The Bristol Inquiry

Although GPs aren't in the dock for this one, part of the evidence focused on local knowledge and whether GPs should have heard rumours and insisted that their cardiac patients were treated elsewhere.

Alas, most of us know less about the quality of care in the hospitals we refer to than our patients, but it could be argued that we have failed in our duty of care to patients if we refer them to a unit that turns out to be distinctly sub-standard.

Certainly there are medical negligence lawyers who would argue this, even when the only 'hard' evidence is rumour.

Apparently, there's a surgeon in the North West known locally as the Terminator…

The death of the part-timer

In New Labour's new NHS, you can't do just a couple of sessions a week and be competent. For years, GP retainers, medical politicians, media tarts and academics have 'kept their hand in' by seeing one patient a month.

But many are quietly giving up before revalidation and reappraisal catches them out.

So the very people who decide what makes a competent doctor won't be seeing any patients at all. And given that 60% of medical graduates are women and half of these will be part time within 5 years of qualification, the future for GP recruitment looks very dire indeed.

The golden goodbye

Having finally spotted this imminent manpower crisis, Tony Blair is now offering clapped-out 60-year-old GPs the chance to stay behind the wheel until 65 for the princely sum of £5000 (or 18 pence an hour after tax).

Before you all jump at the chance, consult an actuary. Apparently, if you retire before 60 you're likely to live until 78, but if you stay to 65 you'll be dead at 68. So this generous gesture is going to save the treasury a small fortune in pensions.

The BMA's mass resignation ballot

Few things are more embarrassing than the large-medallion brigade at BMA House flexing their political muscle, but how many of you would really call the Government's bluff and resign?

Are you trained to do anything else?

Is it easy to work privately?

Are you mortgaged up to the apricots?

Do you have a high-maintenance partner?

And besides, it's a fantastic job really, isn't it?


Guidelines in Practice, June 2001, Volume 4(6)
© 2001MGP Ltd
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