Jhe recent substantial increase in criminal violence in doctors’ surgeries across the UK should be a wake-up call to the Health Secretary and the public. The pressure on primary care has been mounting for years. The situation is now increasingly alarming for doctors and patients alike. A freedom of information request from the British Medical Journal (BMJ) revealed that police record an average of three violent incidents in doctors’ surgeries each day. GPs told the Guardian that angry patients had kicked down doors and threatened to stab them.
This is dangerous for doctors and other staff, especially receptionists in public areas. While attacks on hospital staff have also increased, the dynamic is different in medical practices, which are smaller and do not have the same security features.
Ministers have been promising for years to address the shortage of GPs in the UK. In 2015, when he was Health Secretary, Jeremy Hunt pledged to increase the number of GPs in England by 5,000 – a number later increased to 6,000. But the number of family doctors fell . From 29,364 full-time equivalents in 2015, the overall figure has fallen to 27,939 in 2020. There are also shortages of GPs in Northern Ireland, Scotland and Wales.
Besides the threat of violence itself, the obvious risk is that recruiting and retaining family physicians could become even more difficult. The irony is that becoming a doctor is widely considered desirable, and getting into medical school is highly competitive. But evidence from a growing number of people leaving the profession shows that for many the work fails to live up to expectations – or that over time the stress begins to outweigh the rewards.
When she retired, Clare Gerada, former president of the Royal College of General Practitioners, described how sad she felt at how her relationships with patients had been ‘eroded and devalued’. A third of GPs plan to leave their jobs within five years, according to a survey in April. The proportion among those over 50 was two-thirds.
Lack of investment is a big part of the problem. Parts of the NHS have been running empty for years. Ministers’ refusal to accept the need for a long-term workforce strategy, with clear recruitment targets, seriously undermines Tory claims to back the NHS. By letting these holes in the workforce continue to grow, they jeopardize its future and create opportunities for private healthcare companies.
But underfunding is only part of an increasingly complex health policy picture. The reality, recognized by doctors and policymakers, is that health care has become more complicated as increased longevity and advances in medical science have led to more people living longer with multiple conditions. Rising rates of obesity and dementia have placed new demands on health and care systems. Brexit also played a role. Professor Martin Marshall of the Royal College of GPs accuses ‘insane’ immigration rules of making recruitment more difficult.
Last year, Sajid Javid recklessly engaged in a press campaign aimed at pressuring GPs to restore pre-Covid working practices. BMJ research shows how irresponsible some of this rhetoric has been. Ministers are expected to speak on behalf of GPs and explain how they plan to address the mismatch between demand and capacity. The situation in NHS dentistry, with some areas now ‘dental wastelands’ where those who cannot afford private treatment, is a cautionary tale.