I haven't blogged for a while. The reason will shock our esteemed Prime Minister. It's because I've been a bit busy - see Mrs May, I'm a GP. So waking up on Saturday to hear your briefing to the press suggesting that I am to blame for the current crisis in the NHS, and that you will 'order' me and all my colleagues to be open seven days a week, 8am to 8pm, made me pick up my laptop.
Are you mad?! I am. I am so absolutely spitting mad that I don't even know where to start.
The current NHS crisis - here's some news. It's your fault. Yours and your government; you have called austerity and slashed budgets across the NHS and social care. Beds have been cut. There's nowhere for patients to go to when they need help in the community. There aren't enough nurses. There aren't enough doctors. The stories of people laid on trolleys for hours, and sick children propped up on plastic chairs - that is on you. Remember those junior doctors warning about a crisis? Bet you are wishing you'd listened.
You say that GP surgeries are to blame. This implies you think that while hospitals are collapsing, we are sat drinking tea. A 'normal' day for a GP is now 14-15 hours long, seeing over 50 patients a day, with more home visits than they can manage. Endless blood results and letters. Seeing sick patients who have been discharged from hospital too soon because there were no beds. Trying desperately to keep patients at home because going into hospital is more dangerous than being treated in the community. Every Thursday morning, one of my best friends sends me a message. At 7am she is at her desk seeing patients. Every Saturday night, another friend texts me from his clinic. We are there, working hard every day. Not for you, because for you this is a political game, but for our patients who need us. It is a four week wait to see a GP for a routine appointment now; why? It's not because we are sat on our backsides, it's because there aren't enough of us. The hospitals are busy, general practice is busy, and we don't have enough staff. But you know this don't you? Because you made a big show of promising thousands more GPs, and thousands more staff in primary care. I can't understand then, how on one hand you acknowledge there is a problem and pledge to fix it, while pushing us over the cliff edge with the other.
The vitriolic press briefings say some surgeries "shut their doors". Let me explain that - for those of us who live outside Westminster, often the only way rural communities can have a GP service at all is with a branch surgery. This is a small off-shoot of the main surgery, in an area of need. The main surgery is always open - you can ring or walk in. The branch surgery isn't and that's because it is an extra service; done for patients so they don't have to travel. Practices don't have to do this. We aren't made to and we don't get paid more. We do it because patients need us - but we don't have the GPs or nurses to run two full surgeries all the time. While we are on that, we don't have the staff to run one surgery.
Some surgeries close for half a day three or four time a year, and the out of hours service covers - guess why they do this? It's so the doctors and nurses who work there can have some time to keep their knowledge up to date. We need time to train, and learn about the new medications our patients might need. When would you like us to fit that into our slightly busy schedule, or would you prefer that we are ignorant and just plough on with opium cough mixture and poultices from the good old days...
There is ALWAYS a GP service for urgent problems. It might be at a main surgery, not a branch surgery. It might be a phone-call to the out of hours GP. But it is there and you have, in one fell swoop, spat in the face of all those doctors working hard to prop up the system you have failed.
I worked in four different GP surgeries this week. All of them were at least one doctor short on the day I was there. Two of them have no regular doctors at all, and are staffed entirely by locums. In another the nurses are also not permanent staff. The staff there are demoralised at working without enough support. The patients are embarrassingly grateful because they know how much pressure the NHS is under. The only person who doesn't, is you.
The average GP surgery gets £136 a year to provide unlimited care to patients. As many appointments, home visits, blood tests as they need. It costs more to insure a pet hamster for a year. It costs more for a patient simply to walk into A&E. But you still won't fund general practice so we can do the job we always have - 90% of patient contacts with the NHS are with GPs. Why are you so determined to get rid of us?
I heard the interviewer on Radio 4, asking a colleague of mine what he would say to you. Let me answer too:
"Mrs May, accept your responsibility as Prime Minister. The NHS is failing on your watch, and I won't be part of it any more. I will defend my colleagues, and my patients because you aren't. Your legacy will be the deaths of innocent patients, and as the Prime minister who was too arrogant to listen. Congratulations."