Thursday, 2 October 2014

Whining doctors

I tend to write about 'public health' quacks on this blog rather than proper medics, but every now and again something like this crops up...

Ageing GPs 'may force practices to close'
Hundreds of GP practices are at risk of closure because of the ageing workforce, doctors' leaders say.
An analysis by the Royal College of GPs has identified 543 GP practices out of the 8,000 in England it believes could be forced to shut in the next year.

They all have over 90% of their doctors aged over 60 - the average retirement age is 59.

Firstly, boo-hoo for the poor doctors who retire at the average age of 59 while the rest of us work to 65 or later to pay for them and their massive pensions.

Secondly, workers get old and can be replaced without their businesses having to close down. It may well be true, as the BBC article says, that one in sixteen GP practices are staffed by older workers, but that does not mean that they 'risk closure'. That would only happen if the UK could not import GPs from abroad or was not training GPs at home. But we import many doctors from abroad and—as Nick Triggle (for it is he) admits in the article's final sentence—the number of doctors being trained in the UK is rising:

But the Department of Health said it was investing in new GPs. It said the number of GP training places was rising. Last year there were just over 2,700, but by 2016 it will hit 3,250 a year.

So this is just the usual scaremongering lobbying from a particularly plump vested interest. And, as always, it is about money:

RCGP chair Dr Maureen Baker said extra investment was needed just to keep the system afloat - never mind expanding it.
She said the amount spent on GPs as a proportion of the NHS budget had been falling in recent years, and needed to increase from the current "historic low" of just over 8% to 11% by 2017.

The amount spent on GPs as a proportion of the NHS budget is a red herring. The NHS budget increased threefold in real terms under Labour and is still increasing, albeit at a much slower rate since the recession. GPs' salaries also went up dramatically under Labour. The fact that anyone in the NHS has the nerve to complain about a lack of money after this staggering spending splurge is appalling, let alone doctors who have had their mouths stuffed with gold from day one.

No one should care about whether the amount spent on GPs has risen in proportion to the incredible largesse that has been enjoyed by the rest of the NHS. The only relevant statistic is whether the number of GPs has fallen relative to the UK population—and it has not. It is true that Britain has fewer GPs per 1,000 people than many other rich countries, but this has always been the case under the NHS and if that were to change it would have happened when Gordon Brown was throwing almost unbelievable amounts of taxpayers' cash into this money pit.

As is customary with this sort of special pleading, there is the usual claim that services are on the brink of collapse:

Comparing general practice to the "walls of a dam" that prevents the rest of the NHS being flooded, Dr Baker said: "So far much of the damage to the dam wall has been hidden from the public - they see the flooding downstream in A&E departments and in hospital pressures - but they haven't been aware that GPs, nurses and practice teams have been absorbing that pressure by trying to do more and more with less and less.

"But if we let that situation continue we will see whole chunks of the dam fall apart when practices have to shut their doors." 

Blah, blah and, furthermore, blah. I've been told that the NHS is on the brink of collapse my entire life. You only have to click on Google to see how often the NHS has supposedly been in this perilous situation. It's a bluff. It ain't gonna happen. It's a publicly funded state behemoth and cannot go bust. At worst, it will give some patients poor care and treatment, but it always has and it always will. Moreover, those patients who receive adequate care will continue to feel pathetically grateful for their 'free' healthcare that actually costs them over £2,000 a year.

Like all public services, the NHS should be on the brink of collapse. If it wasn't, it would be even less efficient than it is. But it will not, and cannot, actually collapse. It will continue to suck increasing amounts of money from taxpayers ad infinitum, much of which will continue to go to fat cat doctors, consultants, lobbyists, public health parasites and—above all—bureaucrats.

I don't know whether the current reforms of the NHS are a good or a bad thing, but I cannot remember a time when doctors' lobby groups weren't predicting the end of civilisation as we know it unless they were given more money. I would be less inclined to regard them as a reactionary, grasping, scaremongering special interest group if, at any point in living memory, they had ever seemed to be reasonably content to be engaged in well remunerated and secure employment (see also: teachers). The fact that large numbers of them also wish to restrict our freedom is incidental in this context, but it only adds to my conviction that they should shut up and get on with their job.

1 comment:

drplokta said...

That three-fold (actually 2.9-fold) increase in NHS funding under Labour is in nominal money, not real money. They then go on to say it represents a "sustained increase in real terms", which it does but not a three-fold increase. It's about a doubling in real terms, or an increase of around 50% as a proportion of GDP.