In the UK, where primary care is pretty much 100 per cent State controlled/socialised, the lid has been sinking on GP income and service provision and, more importantly, on professional wellbeing. This has been brought about by bureaucratic micromanagement, stagnant funding and increasing workload requirements and intensity.
GPs’ spirits have been broken and those aged in their late 50s are leaving the profession in droves, not to be replaced, in their case supported by high-value State pensions. There are plans to dramatically increase numbers of GPs there, but this is clearly not happening.
Due to stealthy political manoeuvring in New Zealand, general practice has been split into various artificial categories, for example, high-cost/low-cost access, different age bands, spurious demographic assumptions, the disconnect between Community Services Card possession and true personal means, all with associated significant ongoing management costs.
It has been a train wreck exemplar of Strategy 101, with divide and rule the main tactic of government.
General practice ownership is moving to corporates, with the real effects yet to be determined. Buy-outs are frequent news. The result is lost opportunities for young doctors to join the profession as independent professionals.
More GPs could be trained, perhaps, but that will not be a solution if there is no true incentive or government respect, at a deeper level, for buying a practice and being an independent GP. And so the current decline will continue.
It is time for the Government to be even-handed and transparent with both the public and GPs, rather than just using this as an eternal political football and a chance to look good.