Survey finds GPs sick of reform

A quarter of GPs are so depressed with their work that they would choose a different career if they had their time again, according to a nation-wide survey of family doctors. It found half the respondents believed NHS reforms, designed to give them greater control, have made their jobs harder.

The survey paints a picture of GPs unhappy in their work and reluctant to offer innovative services. They are uncomfortable with computers and do not feel confident to manage their practices. Researchers from the University of Nottingham, who questioned 900 GPs, found a tiny minority of business-minded doctors who had embraced the reforms.

"A majority of GPs are disenchanted with the changes and see them as constraining what they do rather than empowering them on behalf of patients," concluded the report.

The researchers put the GPs into three categories: "disenchanted", "true entrepreneurs" and "traditionalist" family doctors. The disenchanted group accounted for 54 per cent of non-fundholding GPs and 40 per cent of fundholders.

The entrepreneurial group, 38 per cent of fundholders and 22 per cent of non-fundholders, believed reforms have helped them make efficiency savings. They were the most likely group to own their own premises and to carry out customer-satisfaction surveys. The "traditionalists" tried to carry on doing the job as they had done before the reforms came into place.

The research was carried out to assess the response of GPs to NHS reforms brought in in 1990 and designed to give family doctors direct control of their budget for each patient.

The reforms were intended to foster innovation and efficiency by allowing GPs to deploy resources in the interests of their patients.

Brian Goss, a Suffolk GP who sits on the British Medical Association's general medical services committee, said he was not surprised by the findings and recognised the three categories. He said the reforms had been widely disliked, though some GPs had tried to work round them. "It was a thousand pities that it ever happened. It was quite unnecessary and nobody ever benefited from it."

The findings of the Nottingham study are to be presented to the Department of Health.