As promised a short dissertation on why General Practice is worthwhile,
response by 7/9/96??

The political and social changes in Britain in the 1990's and the effect of
three conservative governments has totally changed the practice of medicine,
in secondary care as well as primary care. We cannot pretend that we are
alone in our discontent with the system.  The economics of medicine are now a
major player in decision making whether we like it or not. Most of the
unhapiness in General Practice stems from the results of these changes. We
feel overworked, under pressure and underpaid.

 The fundamental job we do has not changed, however, and it is this that is
most important. It is the day to day contact with real people who need our
help/advice/support that makes it worthwhile. There are in effect very few
things we can cure, many things that we do not understand and unfortunately,
many things that we know could be done better with better resources. The
simple pleasures of improving the condition of ones fellow human beings and
their resulting gratitude overrides the frustration and dissapointments
engendered by the changing circumstances. We mostly entered into this strange
profession because of the contact with people and their problems. The
intelectual stimulation of the endless possibilities of what might happen
next only adds to the positive side of primary care. The patients and their
problems are the thing that is most interesting and satisfying about
medicine, they are still the same even if the working enviroment has changed
beyond recognition.

One of the major problems that we have faced, and to a great extent overcome,
is the change itself. Most GP's now have a better idea of the commisioning
process and many will be greatly empowered by the ability to influence the
direction of health care provision. We are turning the corner, I feel, and to
give up at this point would be to throw away the best system of Primary
Health Care in the world. The next few years will see further change in the
mechanisms of health care provision, but not on the scale that we have seen
before. The fall in GP recruitment and the loss from the profession of
experienced GP's through ill health and early retirement will cause many
problems, but can only serve to strengthen our hand in negotiating better
terms and conditions of employment with the government.

It is very easy to list all the things that are wrong with our situation. We
must look at the changes as a necessary evil ( like most doctors look at
their computers) and build on the trust and confidence the vast majority if
our patients have in us as healers, to allow us to continue serving them.

Trefor Roscoe                      Email; [log in to unmask]
Beighton Health Centre        Tel 0114 - 269 5061
Queens Road, Beighon        Fax 0114 - 269 7186
Sheffield S19 6BJ


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