It\’s all about the female GPs

The NHS is facing a chronic shortage of family doctors after official figures showed some GPs were responsible for 9,000 patients.

So that\’s the basic problem. And no, it\’s not all about the female GPs, but it is at least in part:

There are also concerns that the growing number of female GPs, many of whom work part-time because of family commitments, will lead to further shortfalls.

Two thirds of trainee GPs are women and research by the Royal College of Physicians has found that women GPs will outnumber their male colleagues by 2013.

Dr Sarah Wollaston, a Tory MP and former family doctor, said: “It creates all sorts of pressures as women take time out with family commitments. There is a real risk of a shortage.”

Obviously and clearly having (or soon to have) a majority female profession is going to change the working habits of that profession. Even just in our little blogging community we know of one female GP who is working part time as the kids reach towards 10 years old (ish).

We thus need to have rather more GPs than we used to given that so many of them are going to do this part time working thing.

Which leads to two rather interesting points.

The first being, should we really be paying female GPs the same as male? There\’s an argument that we shouldn\’t be. For it costs some £250,000 to train one, all paid by the NHS. In a 30 year career (few if any qualify before 30, 60 is not an unusual retirement age) we, having paid for that training, might get 15 years of full time and 15 years of part.

It thus costs us more to employ female GPs…..shouldn\’t they thus get lower wages per hour?

The second is, well, this was a bloody obvious outcome of the combination of moving to a female majority profession plus allowing part time working, career breaks and so on. So why do we actually have this problem? Isn\’t the NHS a beautifully State planned organisation? Don\’t we have caring and omniscient bureaucrats who manage the whole thing as an integrated system?  Isn\’t this, something that has developed slowly over the last couple of decades, something that such planning, such omniscience, should be able to deal with?

Or should we argue that, given that the planners obviously didn\’t see it for we do have this problem, the planners are fuckwits?

Or even, to be extreme and outrageous, argue that if the planners cannot deal with something so glaringly obvious, that planning itself isn\’t all it\’s cracked up to be?

10 comments on “It\’s all about the female GPs

  1. Training costs should be treated as capital expenditure, ie, the costs are sunk and the GP’s work is then contribution, not return on capital, which is a Banker’s wheeze to extort even more cash out of an enterprise. It isn’t then a gender issue at all. Any GP working part time gets paid pro-rata, at rates which are the same for both men and women. End of story. As to centrist planners not being capable of organising a bunk-up in a brothel, that’s taken as given isn’t it?

  2. Years ago I heard a heated debate between two medics, one a feminist who wanted more girls admitted to medical schools, and the other a reactionary who said no, they wouldn’t pull their weight in the profession because of having children. I cheerfully remarked that they were both right and so if more girls were to be admitted on merit, the schools would have to expand to cope with the inevitable fewer working hours per head. They both turned their ire on me.

  3. I agree with GOM’s comments as far as they go. But in those practices where there is still a doctor “on call” for emergencies outside surgery hours, guess who it will be? So you need to identify the meaning of “pro rata”.
    Also part-time working is least bad when work can be timed to fit the part-timers’ schedule or when two part-timers choose to have complementary working hours. The latter is just not plausible when they are both mothers of school-age children, so you need a majority of full-timers in every practice. You can have a majority of female GPs but not a majority of part-time GPs.

  4. Step one is to stop childcare being a gender issue. Once beyond the initial period where the lady needs to be the one not working, there’s just no need. It’s a cultural change that is required.. it can’t be forced or legislated.. or even ‘nudged’.. but I’m seeing more and more shared caring arrangements between hubby and wife.. and resultant part time working for both.

    Get there, and the ‘gap’ in number of hours worked will drop. As GPs are terribly well paid, even if the lady is not the top earner, we can assume that the family will be able to pay the bills if the chap works less hours.

    When we pay to train a GP we don’t know how many hours they will work. So the impact of those who go part time is unknown. We want to get the best return on our investment, so we want as much GP as possible. If we’re going to pay anyone less, the it’s a part timer (you can’t just pay women less because they might go part time one day) but if we do that then we reduce their incentive to work as many part time hours as we wish them to (that being, as many as possible) so, in summary, it’s a dumb idea.

    What next.. we pay all part time people less because they’re making less of a contribution to whatever society invested in their education? How does that help? Or do we just tax them at a higher rate.. no, that can’t be the plan either.

  5. Maybe I’m missing something here, but shouldn’t the bumper pay increase for GPs a few years ago (thanks, Gordon+co.!) result in a higher demand for GP jobs? Presumably there’s a lag of 5-10 years for the additional proto-GPs to make their way through the training pipeline.

    Having been on the receiving end of two God-awful GP surgeries in quick succession (after, it must be said, a first class one in the Avon area) I wonder whether the high body-to-GP ratio isn’t all part of the plan. It certainly does wonders for restricting access for appointments, and hence referrals, and hence significant NHS expenditures.

  6. There is a similar marked trend in Australia. Which is interesting because our system is based around private practices with a large percentage reimbursed by the govt. A small group of female GPs get together and start a practice, all working part time, and divvy up the hours to provide a continuous service. Where I go there are 5 GPs. If I want to see my regular doctor I need to book ahead, but in an emergency there is someone there. Similar arrangements are popping up with specialists as well. Especially in O&G which has always been a particularly brutal field in terms of working hours.

    What I find intriguing about this is that it’s not driven by rules or regulations, these are purely private partnerships. The arrangement is strictly their choice. Works for all of them, so they’re all happy.

  7. A lot of the education cost here is recovered through a government run interest free loan system (they effectively garnish your wages via the tax system, the Higher Education Contribution Scheme). And wages aren’t set, they basically take home whatever split of the partnership profits they have. So that doesn’t really apply either.

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