expert jury: should we take more care of NHS doctors?

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The Independent Online
Do we undervalue our doctors?

Dr John West

London GP

I usually work an 11-hour day, but even then I have to put things off for the morrow. It would be quite possible for me to work 24 hours a day with my workload. We don't have an hourly structure, rather we are self- employed, so the job revolves around a numbers game to earn the income to afford a mortgage and a good standard of living. Having said that, the work is very gratifying, and less than 5 per cent of patients are unpleasant. There is job security and respect from the public. But since 1990 we are meant to carry out more checks on each patient, which means less time for patients and more consultations. But doctors are always moaning and groaning; it is very hard work, but it is also very rewarding.

Dr Ruth Brown

London GP

GPs and hospital doctors are very different, and a lot depends on the status of the surgery and whether it is in a high deprivation area or a leafy suburb. However, it's always a high-stress profession which is not helped by the Government raising people's expectations; the temptation now is to blame the doctor. I think the whole NHS is very good value, and I have no quarrel with the work I do, but we are paid quite a bit less than in most other countries. I think that there will be an exodus from the service in the next few years because of the stress, and also now that doctors can retire at 50.

Dr Peter Holden

British Medical Association

Doctors work very hard indeed. Consultants are paid for 38 hours a week, yet often do 55 with no overtime. Junior doctors frequently do 72 hours a week, and well over 25 per cent of GPs do up to 84 hours. People expect doctors to be on call all the time, including weekends. This is simply dangerous. At least policemen get meal-breaks and days off, although teachers also have a bad deal. A GP's job is not particularly financially rewarding because one is liable for everything. Jerry Malone's recent settlement is just a new carving up of the same pay, and the Government is also to blame for the perversity of the system.

Alex Carlile MP

Liberal Democrat Health Spokesman

Some doctors are indeed overworked. It is not pay but pressure which is behind the out-of-hours issue. Demands are made by patients who cannot distinguish between day and night. One system might be to penalise patients who break appointments, by charging them maybe 50 pence each time: 5.2 million hospital appointments were not kept last year. Perhaps also, the elderly could be treated primarily in hospitals and not by GPs. The first aim must be to serve patients, the second to ensure that a doctor's workload is reasonable. However, there is a serious shortage of doctors now, which remains a problem.

Dr James Le Fanu

GP and Daily Telegraph columnist

Although older doctors are generally satisfied with their jobs, some 50 per cent of doctors who qualified in the mid-Eighties now say that they wish they had never started. The rate of innovation has slowed dramatically; medicine is more boring now, because you don't get the same sort of pathology that you used to. Medical progress has halted - there haven't really been any great breakthroughs in recent years. And there is a problem with call- outs; night calls can only work if there is a mutual trust between doctor and patient, yet the Citizen's Charter implies that it is a patient's right to call a doctor out any time they want to.

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