Dr Angela Goyal: The NHS is in crisis - but is it really the GPs fault?

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We have heard yet again that the NHS is in crisis. In fact we hear this a lot. Every winter for the past few years there is a “winter crisis” The British Red Cross recently called it a “humanitarian crisis.”

The NHS is at breaking point both in hospitals and the Community but I wouldn’t call it a crisis. A ‘crisis’ according to the Oxford English Dictionary means “a time of intense difficulty or danger” This implies something temporary. The NHS has been in a close to the edge for years.

Dr Angela Goyal, at the Leeds Student Medical Practice, Leeds.25th January 2017 ..Picture by Simon Hulme

Dr Angela Goyal, at the Leeds Student Medical Practice, Leeds.25th January 2017 ..Picture by Simon Hulme

I am well aware of the NHS being in severe trouble. I feel I on my part do my utmost to do the best I can for the NHS. For a long time now GPs have been working extremely hard under huge strain with limited resources and trying to manage an ever increasing workload under immense scrutiny.

So I was utterly disappointed and saddened when the news story came out last week that our Prime Minister was widely reported in the press for saying that GPs were to blame. These comments were unreasonable and far from the truth.

This is my story. I’ve been a GP for about 14 years now, and worked at a few surgeries in Leeds. I love my job and always go the extra mile to ensure I care for my patients well.

I’ve never had an easy day. It’s always rushing from one thing to the next, each task vitally important for a patient’s health. I generally squeeze in a quick lunch, on the go, due to the sheer volume of work I have to get through. I have children of my own and juggling being a doctor and mother has not been easy. I’ve frequently rung my childminder … “please can you stay, I’m still at work”. Being a doctor where the patients come first means we can’t just leave at a set time.

If a GP surgery looks like it is not busy I guarantee that GPs will be busy behind the scenes. There are numerous patient letters, blood results and other test results to check carefully as they may involve contacting a patient, prescribing a medication or some other action. So, if the last patient seen in the surgery is say 7pm then the GPs could still be there for a few hours after that. General Practice is struggling to cope with the volume of work. Patients increasingly have complex medical needs and a 10 minute appointment often does not suffice. I do go the extra mile for my patients. I know most doctors do. This means spending extra time with someone because you know they need that from you. Without a doubt it does impinge on your home life but it is all worth it to make people better and make a ‘real’ difference.

I guess that is why I am so troubled with the comments from Downing Street. My hard work seems unappreciated by this government. And they just don’t get it. We are not the cause of the problems of the NHS, in fact, we are the ones who are propping it up! We keep people out of hospitals by managing them in the community.

When services are cut in the hospitals the burden moves to us in General Practice and we take the workload on so patients don’t suffer. Out of hours GP services are available to all, even though the government don’t seem to know this. I can understand that patients may want to be seen by their own local GP but to try and have this 7 days a week, with no extra funding, would mean severely compromising the quality of care of an already overstretched service.

Even Tory MP, Dr Sarah Wollaston said after the news broke, it was wrong for GPs to be scapegoated for the complex problems in the NHS and the government should apologise to GPs The reasons for the crisis in the NHS are complex and multiple. Here are some reasons why I think we are in this position:

Years of chronic underfunding – worsened by austerity measures.

An ageing population with increasing complex health needs- health care funding not risen to meet demand. Too few doctors or nurses from cutbacks and lower recruitment.

Social care budgets cut – this means there is nowhere for patients to be discharged to – we call this bed blocking. I’ve seen first hand that this has been a problem since I qualified as a doctor in 1997.

Expensive new drugs. Not enough emphasis from the government on making it easy to eat healthily. For example we live in a society where 60 per cent are overweight or obese, which impacts massively on healthcare costs. It is cheaper to buy processed unhealthy and sugary food and drinks than fruits and vegetables.

Not enough greenspace and cycle paths to help people exercise easily – even though we know that regular exercise prevents ill health more than drugs do. Anyway, after hearing the unpleasant “news” in the media it was lovely to receive a thank you card from a patient and letter from Dr Sathiyaseelan who is the head of the Leeds Medical Committee. This reminded me of what a good job we are really doing.

A full version of his letter is printed alongside this article. It was sent out on January 16.

Dr Angela is a GP at Leeds Student Medical Practice where she has interests in sexual and mental health. She has a specialist interest in dermatology and holds dermatology clinics at Street Lane Practice.

Dr Angela gives teaching seminars for other doctors in this subject. She is passionate about advocating healthy lifestyles to prevent illness. Away from the surgery she likes to spend time with her family and keeping fit and healthy.

Facebook: facebook@drangleagoyal

Twitter: @drangelagoyal

Leeds medical committee chair praises local doctors

Dear Colleagues

We are writing to say thank you for all the work that you and your practice team are doing.

Thank you for the extra mile you often go to make sure that patients are cared for.

Thank you for being a dedicated professional who excels at their job in the most difficult of circumstances, working within the most challenging environment and with insufficient resources.

Thank you for all the care you give in seeing thousands of urgent cases throughout the day in your surgeries and working out-of-hours, working together to ensure every patient in Leeds has access to a GP 24 hours a day, 7 days a week and every week of the year.

Thank you for being there when other services are limiting what they do, and for all the work you do which isn’t even yours but passed to you from elsewhere but which you do because it is in the best interest of your patients.

When the focus is all too often on A+E and hospitals, it’s all too easy to forget that GP practices are the foundation of the NHS and that you are as busy, hardworking and dedicated as everyone else doing their best to keep the NHS going.

We know the pressures you are under, we know how hard you work in the most frustrating of times, we know you do it not for the money but actually because you do care.

Threats and bullying on such a scale and gravity as happened in the media this weekend as a result of briefings from the Prime Minister’s office are unacceptable, unjustified and demoralising. To blame an overburdened, struggling, understaffed workforce for the failings of an under resourced system is shameful. Even if some politicians don’t appreciate or understand what you do, we know that you and your team are the NHS’s most valuable asset and without you the NHS would fail within days.

So today, hopefully a patient or colleague will thank you for some small thing and it reminds you why you do this job.

If things aren’t good please talk to a colleague, a partner, or us at the LMC. The pressure is there and we all know that, so if we can support in any way we are here to help.

Please take good care of yourselves and each other.


Medical Secretary, Leeds Local Medical Committee Limited