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Thursday, 20 June, 2002, 17:20 GMT 18:20 UK
'We need a new NHS contract'
Dr Liz Bainbridge and family
Liz Bainbridge wants to spend more time with her family
Doctors from across the UK gathered in London this week to discuss a proposed new contract for every GP working in the NHS.

The British Medical Association, which agreed the framework of the new deal with NHS managers earlier this year, believes the proposed changes will reward GPs for the work they do and will transform their working lives.

Doctors across the country are voting on the measures this week. If the vote is passed, the BMA will resume negotiations to finalise the financial terms of the deal.

BBC News talked to two GPs who explained why they want to see major changes to the way they work.

Dr Liz Bainbridge has been a GP in Liverpool for the past 11 years. Although, contracted to work part-time for the NHS, a shortage of doctors means she works much longer.

Dr Liz Bainbridge
Dr Bainbridge is considering leaving her job
She treats 30 patients every morning and is having to cope with an increasing amount of paperwork.

< She is considering leaving the practice and becoming a locum doctor unless the situation improves.

"I love the job. I love the people. I enjoy the job. I enjoy medicine. But we are understaffed and I'm doing three people's jobs. It's too much.

"I could bear this for three months, six months or nine months but not forever. If I had 48 hours every day I'd be fine."

Dr Bainbridge wants a better balance between her working and family lives.

"I can't sustain this workload for very much longer. I've got a big family and I chose to have that family because I want to be with them.

"Locums are able to choose where they work. The main issue is the time.

"The advantages would be that I would actually just be more or less doing what I enjoy which is patient contact. I enjoy that. That's the good side you never know what's going to happen.

"The downside to it would be that I've invested a lot of time here. I know the people here and I would miss that.

"But this amount of work is unsustainable."

She supports the proposed new contract for GPs but wishes more could be done to improve working conditions now.

"There are things that could be very helpful and there are things that I would change but it's all things for the future and we really need to change what's happening now.

"We are at least 50 GPs short in Liverpool. Patients have suggested that we drop the patient numbers. But there's nowhere else for them to go.

"If myself and my part-time partner resigned there would be 5,000 people without a doctor. There isn't room in any of the other practices for them."

Dr Graham Hurst has worked as a GP in Hartington near Buxton for the past 15 years.

Dr Graham Hurst
Dr Hurst says GPs are stressed and under pressure
He came close to leaving his job last year, frustrated with his 70-hour working week. He and his GP partner have now taken on another doctor, who works part-time, to share the workload involved in treating the 3,200 patients on their books.

Dr Hurst still regularly works 50 hours each week and hopes the new contract will help him to improve his working life.

His main priority is to reduce the amount of time he spends on paperwork. He believes the contract proposals will help him achieve that.

"The amount of paperwork we do in a working day is probably about half the time we would spend with patients. For a two hour surgery you have to sit down for at least one hour."

Writing out medical notes and referral letters for hospital appointments take up a lot of time.

"There's an awful lot of paperwork and in addition to that general practice is quite a complex business," he says.

"We are in the middle coordinating everything. It does take a lot of time."

Dr Hurst would also like to see changes to the way the government manages the NHS.

"I would like to see fewer changes in general practice. There are a lot of political changes which are government driven," he says.

"A lot of these changes are good changes but they are being forced upon us at the government's pace.

"While some practices are ready for these and can do it quite easily, other practices are just not ready for these changes and they have a lot of disruption while they just try to catch up."

"The government should stop putting more and more pressure on us to do more and more work.

"The other thing that is really getting to people is the job we do with patients is getting more complex.

"We are now managing a lot of conditions that would normally be done by hospitals so we are expected to know more and more, do more and more for our patients and become experts in more and more things.

"While most GPs actually enjoy that, it is very time consuming.

"It is quite demanding and quite stressful."

He believes the proposed new contract will help to make a difference.

"It will give us freedom. It would release us from a lot of the administrative controls we have got so GPs could focus more on what they're good at and what we want to do which is patient care."

The BBC's Jill Higgins
"NHS reforms have made things worse"
See also:

19 Jun 02 | Health
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01 Jun 01 | Vote2001
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