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Wales Online
Wales Online
Health
Mark Smith

Welsh doctor says more GPs are needed to avoid 'complete collapse' of service

A doctor claims more GPs are urgently needed across Wales to avoid a "complete collapse" of the service. Dr Farookh Jishi, a retired surgeon who represents doctors across north-east Wales, described general practice as " underfunded, understaffed and overworked".

He was speaking at the British Medical Association's (BMA) annual representative meeting in Brighton this week where his motion, which called for a boost to training places at undergraduate and post graduate level, was passed. His motion also stated that there is a "recruitment crisis" in primary care in Wales and urged the Welsh Government to improve terms and conditions of service and use more incentives to attract applicants.

"GPs are the backbone of our National Health Service. Some would say that GPs are one of the pillars of the local community. Yet it is a sad state of affairs that this service is under great stress and has been for some time, even before the Covid pandemic," he explained.

Read more: The overcrowded Welsh prison failing to look after the healthcare needs of inmates

"The service is underfunded, understaffed and overworked. Patients are getting a raw deal and are increasingly frustrated in trying to see their GPs. Doctors are taking the blame and being called lazy, while in fact they are experiencing burnout. The problems in secondary care, with its backlog of waiting lists, is increasing the demand on GP services. How can an understaffed service cope with increasing demand?

"The issue of understaffing needs to be addressed urgently to avoid a complete collapse of the service."

Dr Jishi said as many as 19 practices in north Wales have handed the keys over to their health boards, resulting in the "inevitable fall in efficiency". He added: "The situation is only going to get worse in the coming years. Some 25% of GPs are over the age of 60 and 50% over the age of 50. The non-resolution of the pensions issue, low morale and the feeling of burnout will inevitably lead to some opting for early retirement. Recruitment must match the vacancies and more.

Dr Farookh Jishi (BMA Cymru)

"Increasing training places and the new north Wales medical school will take years to make a difference and is but one part of the solution. GP practices must be incentivised to train more recruits. It should also be remembered that there is a competition for places with surgeries in England. This is especially so in border regions like north-east Wales, the constituency I represent. Incentives and innovation, in addition to financial incentives, are required to improve recruitment and retention."

He said one answer to attracting new recruits would be to invest in "well-designed and purpose-built" GP surgeries with good IT infrastructure. "We should lead the way in sharing the workload with our colleagues in pharmacy, physiotherapy and other services to improve patient care and make the health service more attractive," he said. "The mental and physical health benefits of working in rural and semi-rural areas of north wales should be highlighted, with easy access to places of outstanding beauty like Snowdonia National Park and the beautiful beaches of the Llyn Peninsula, to attract and retain trainees."

Jay Panchal, a medical student currently doing his general practice block, said he has seen first-hand how difficult it can be to recruit GPs in rural areas and its knock-on effect for patients who are finding it even harder to seek care.

Medical student Jay Panchal speaking at the British Medical Association's (BMA) annual representative meeting in Brighton (BMA Cymru)

Before his placement, Jay said he had not considered working in general practice and believes giving medical students exposure to rural general practice is key to alleviating the recruitment crisis its currently facing, in turn improving services for patients.

Commenting on Dr Jishi's motion, he said: "Research has shown that rural exposure during undergraduate medical training is promising as a means for overcoming the shortage of GPs outside urban areas, as seen in Australia and Canada, for example."

He added: "I had not seriously considered general practice, let alone rural general practice before my current placement, but it's now one of my top career choices. More surgeries should be given the opportunity to host undergraduate students, and I hope more students will consider the career, as I do, in the future.

"Medical schools in larger cities inevitably face greater logistical challenges, but greater support should be given to such schools to allow their students to access such placements. This may go some way to alleviate the recruitment crisis in primary care in Wales, and in turn the rest of the UK."

In response, a Welsh Government spokesperson said: "There has been an upward trend in the number of GPs working in general practices across Wales in recent years. In the last three years we have not only achieved our GP training target of 160 places a year but exceeded it by 90 places. Our Train Work Live marketing campaign played a key role in achieving this.

"The Primary Care Model for Wales places a large emphasis on meeting community healthcare needs through a multi-disciplinary approach. We invested in developing new models of care using a wider group of professionals, including practice nurses, physiotherapists and pharmacists. This method highlights that GPs are not the first point of contact when seeking care and, in turn, provides improved access to primary care services."

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