Here are my comments on this. Please note my declaration of interests - I'm a consultant, my wife used to be a GP (but gave up to become a music teacher) and my sister is the senior GP partner in her practice.
1) Being a GP is actually the hardest job in medicine - the vast majority of patients each day will not have anything serious or life threatening - BUT the GP has to be able to pick out every serious problem out of the large number of minor (not to the patients though) ailments each and every week. It's much easier being a hospital specialist, as the GPs have done the hard work for you. To put this into context, I look after people with breast cancer and see lots of patients with breast problems every week, some of whom will sadly have trouble. The average GP will only see on average 2 new patients with breast cancer every year. I also used to look after people with a rare cancer called sarcoma and would see a new sarcoma regularly. The average GP will only see 1 sarcoma in their entire working lifetime.
2) A GP practice is a self contained business, which is contracted to the NHS. The GP partners have to run the business (finance, recruitment, premises/estates, HR disciplinary etc) as well as treat patients. Sure each practice will hire a practice manager to help with this. The GP partners's monthly drawings will vary according to the costs of running the practice. One of my GP colleagues took home nothing (yup zilch) for his monthly drawings as the senior partner just before the pandemic, as the costs of the practice meant that there was nothing for him to draw.
3) Hardly anyone now wants to become a GP partner, as they don't want the hassle or the financial responsibility of running the practice. Most younger GPs have become salaried GPs i.e. they come to work, see patients, take a fixed salary and don't get involved at all in running the practice. This change has led to an existential threat to many GP practices as hardly any partners are left in some practices, once the older partners retire.
4) All doctors (incl GPs and hospital Drs) were encouraged to triage or do telephone consultations during the pandemic. This was to protect staff and other patients, as COVID was contagious and infected GPs/practice nurse could a) become seriously ill or die and b) clinical staff could pass this onto other patients during the initial asymptomatic phase of the infection.
5) Medicine has become a less attractive career. 20 years ago, we knew that 25% of medical graduates gave up their medical careers within 5 years of graduation. This proportion has increased since then as other careers offer a better work life balance and sometimes better salaries too.
6) GPs usually work very long hours. Most are in before 0800 and rarely leave before 1930-2000. Apart from calling or seeing patients face to face, every GP has to write/check prescriptions, write referral letters to consultants, read the letters back from the hospital about their patients, check any lab tests. The partners also have to take time to run the business side as well.
7) The UK has always had amongst the lowest number of doctor per capita in Europe. This is not improving. As the population ages, the healthcare demands of each patient become ever more complex. Moreover, many of the services previously run by hospitals eg diabetes monitoring, breast cancer follow up etc have been handed back by hospitals to GPs to add further burden to their work.
8) One of the main reasons why the UK has a low number of doctors goes back to the inception of the NHS in 1948. The NHS is a virtual monopoly employer of healthcare staff (in primary and secondary care), unlike virtually every other western country. The private sector in the UK is very small by comparison. University admissions to medical school is regulated by the Govt, which ties this in with workforce planning for the NHS. Medical workforce planning has been derisory for decades. Other countries train far more doctors, as they have co-existing vibrant private and Govt healthcare sectors. That means that if the universities train too many doctors, those graduates have the ability to earn a living in the private sector. This substantial private healthcare provision means that there is less strain on the Govt healthcare system - vis a vis in France.
I'm sure that there are other issues as well, which I have forgotten, but I hope my GP colleagues feel that I have put their case for them.
