David Oliver: Facts the Daily Mail omits in its GP bashing

ACUTE PERSPECTIVE

David Oliver

consultant in geriatrics and acute general medicine

The newspapers owned by DMG Media (including the

Daily Mail and the Mail on Sunday) have been

publishing incendiary articles about GPs for many

years. The covid pandemic and the resulting extra

strain on services have acted as an accelerant, with

headlines badging themselves as crusaders for

patients.

Last week an article appeared with the headline,

“Now GPs want to work even less! Doctors table

urgent motion in a bid to cut core opening hours to

9-5—shaving two and a half hours off.”

The nub of

the story is that the local medical committee (LMC)

in Avon tabled a motion for the national LMC

conference, calling for the core contracted hours of

8 am to 6 30 pm to be cut to 9 am to 5 pm. Meanwhile,

the Cambridgeshire and Cleveland LMCs are

submitting motions on safe workload limits for GPs.

I don’t doubt for a second that many patients are

currently having serious problems with access to NHS

services, including GP appointments. This was

reflected in the latest NHS satisfaction survey.

But

the story in the Mail left out some important facts and

context.

The UK has among the fewest doctors and nurses per

1000 people among the Organisation for Economic

Cooperation and Development countries or the EU.

Numbers of full time equivalent qualified GPs haven’t

increased since 2015 and more recently have fallen.

GPs are leaving the profession faster than people are

entering GP training, and fewer international medical

graduates now come to the UK or stay here.

Yet

annual recorded GP and practice nurse consultations

have increased by 16% in that same period, now

hitting record highs.

A BMJ paper in 2019 showed that UK GPs saw far more

patients daily than their counterparts in 10 other high

income nations. Most patients are satisfied with

online or telephone consulting, with only a minority

preferring face to face (currently around 60% of

consultations).

General practices receive an average of £155 a year

for each registered patient,

for unlimited primary

care: GP partners must cover indemnity, employee

costs, building maintenance, and much more. See

how far £155 gets you in private healthcare by

comparison. The median number of patients on each

GP’s list is over 2000, a rise of around 200 in the past

decade.

We’ve seen cuts to social care, local government, and

community nursing; growing pressures on

ambulances and emergency departments; and scarce

acute beds, compounded by record numbers of people

on waiting lists for planned secondary care. As a

result, GPs can find themselves holding additional

risk or providing unfunded follow-up and

monitoring.

The Mail article used a graph showing that “average

GP working hours per week” were 38.5, compared

with 42 in 2008. This would still be “full time” in

many jobs. And the figure is based on contracted

hours. GPs report working well beyond those official

hours in surveys the Mail acknowledged but glossed

over: it cited low numbers of Saturday appointments

compared with weekdays but didn’t mention the far

lower demand for those slots when they’ve been

opened up.

And many GPs do combine clinical

sessions with other work in education, training,

medical management, or other activities—partly

because of the relentless nature of seeing too many

patients in too little time but also because such

activities are important to the NHS.

It might make for tubthumping headlines, but forcing

GPs into longer hours, with more clinical days, more

contact time, and lower pay, won’t solve the

workforce crisis or improve access for patients, which

the Mail claims as its mission.

Competing interests: See bmj.com/about-bmj/freelance-contributors. David Oliver

is an unpaid trustee of the Nuffield Trust, an unpaid visiting professor at City

University, London, and an unpaid visiting fellow at the King’s Fund. He writes

both as a professional freelancer and unpaid for several publications but has

never been told what he should or should not write about. He has never taken

fees from pharmaceutical companies or consultancies and has never practised

private medicine.

Provenance and peer review: Commissioned; not externally peer reviewed.

Craig E. Now GPs want to work even less! Doctors table “urgent” motion

in a bid to cut “core” opening hours to 9-5—shaving two-and-a-half hours

off.

Mail Online

2022 Apr 25. https://www.dailymail.co.uk/news/article-

10752081/Doctors-table-urgent-motion-cut-core-opening-hours-9-5-

shaving-two-half-hours-off.html

Nuffield Trust. Public satisfaction with the NHS and social care in 2021:

Results from the British Social Attitudes survey. 30 Mar 2022.

https://www.nuffieldtrust.org.uk/research/public-satisfaction-with-the-nhs-

and-social-care-in-2021-results-from-the-british-social-attitudes-survey

Organisation for Economic Cooperation and Development. Number of

medical doctors and nurses. 23 Aug 2021. https://www.oecd.org/coron-

avirus/en/data-insights/number-of-medical-doctors-and-nurses

Rolewicz L. What does the GP workforce look like now? Nuffield Trust. 12

Feb 2021. https://www.nuffieldtrust.org.uk/news-item/what-does-the-gp-

workforce-look-like-now

Rolewicz L, Palmer B. The long goodbye? Exploring rates of staff leaving

the NHS and social care. Nuffield Trust. 9 Feb 2022. https://www.nuffield-

trust.org.uk/resource/the-long-goodbye-exploring-rates-of-staff-leaving-

the-nhs-and-social-care

University of Bristol. General practice in England nearing “saturation point”

as study reveals extent of GP workload increase. 5 Apr 2016.

http://www.bristol.ac.uk/news/2016/april/gps-workload-increase.html

Health Foundation. Analysis finds 10% of patient care requests indicate a

preference for face-to-face GP consultation. 17 Mar 2022.

https://www.health.org.uk/news-and-comment/news/analysis-finds-10-of-

patient-care-requests-indicate-a-preference-for-face-to-face-gp-consultation

1the bmj | BMJ 2022;377:o1091 | doi: 10.1136/bmj.o1091

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Cite this as:

BMJ

2022;377:o1091

http://dx.doi.org/10.1136/bmj.o1091

Published: 04 May 2022

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