There is no shortage of patients sharing shocking stories of how a lack of in-person appointments or being trapped in the endless labyrinth of phone calls and online forms has damaged their health.
And GP surgeries themselves have detailed disturbing stories of overwhelming and dangerous workloads, as well as increasing mistreatment towards staff in recent years.
Against this backdrop of the struggling primary care sector, the NHS celebrated its 75th birthday today.
But records show that the 1950s, shortly after the establishment of the health service, was just as challenging a period for general practice, with GPs having to treat up to 80 patients in a single day.
A 30-page report published in 1950 in the journal The Lancet concluded ‘the general state of general practice in England is poor and still deteriorating’.
In 1948, the British public was given the right to free, comprehensive health care funded by general taxation, but GPs faced challenges, sometimes seeing as many as 80 patients a day. Pictured here is an NHS doctor examining a patient in 1950
The highly critical report, written by Australian general practitioner Joseph Collings, also assessed inner-city practices as ‘at best?deeply unsatisfactory and at worst a positive source of public danger’.
Rehearsal rooms, meanwhile, were “dirty and ill-equipped” with “rusty and dusty antique instruments,” he said.
The report provoked an angry response from the profession at the time, which many thought was unfair.
But Dr Collings noted that the GPs themselves were not to blame, noting, in a claim many will find familiar today, how the profession was constantly being asked to do more work for less pay.
“If the current trend continues, it should lead to the disappearance of the general practice as an effective organ of medical care,” he wrote.
Similarly, Dr John Fry, one of the founders of the Royal College of General Practitioners, in his report ‘General Practice and Primary Health Care 1940s-1980s’ described his experience as a general practitioner when the NHS was formed.
?The maximum number of patients allowed for a general practice director was 4,500,? he wrote.
“Within a few weeks I had over 3,000 registered NHS patients,” he added.
‘The early euphoria in the NHS was short-lived. The 1950s became a period of criticism and counter-attacks on many aspects of family medicine,” he said.
Research published in the BMJ in 2006 also found that GPs in the 1950s were ‘overwhelmed by the demands of their patients in the early years of the NHS’.
It added: ‘The idealism that drove many GPs to work around the clock led to a drop in both morale and standards.’
Between 1947 and 1950, the average number of times a patient consulted the GP increased from 4.8 per year in 1947 to 5.6 in 1950.
In 1953, general practitioners were also estimated to make between 12 and 30 home visits daily, while also seeing between 15 and 50 patients in their operations.
According to recommendations from the BMA and the European Union of General Practitioners, GPs should now make no more than 25 appointments per day to guarantee ‘safe care’.
But reportedly some doctors in some areas are having to cram nearly 60 patients a day during an appointment crisis.
GPs say their operations are overwhelmed by the pressures of a rising and aging population, a lack of government funding and a shortage of doctors. NHS statistics show that as of April 2023 there were 27,231 full-time equivalent fully qualified general practitioners working in the NHS in England. Full-time equivalents correspond to 37.5 hours per week
Top experts today claimed MailOnline’s research illustrates how general practice is an ‘elastic band stretched to breaking point’. Graph shows the ratio between GP patients and practices since 2015, with an average of 9,755 patients per practice in May 2023
Why Britons still struggle to get a GP appointment is complicated.
Nationally, the patient-physician ratio now stands at an average of 2,292, almost a fifth more than in 2015.
Ministers have also quietly rejected a pledge to employ an additional 6,000 GPs, which was a key part of Boris Johnson’s election-winning manifesto.
Since 2019, only 2,000 additional GPs have been recruited.
But the number of fully qualified GPs, who work the full-time equivalent of an average of 37.5 hours a week, has shrunk to around 27,300, data shows.
Analysts think another 7,400 are needed to close gaps.
The staffing crisis is compounded by the fact that many current GPs are retiring in their 50s, moving abroad or working in the private sector due to huge demand, NHS paperwork and aggressive media coverage.
Another factor is that as the number of GPs has been declining, the general population has grown, meaning there are fewer GPs around.
As a result, millions of patients are rushed through appointments, in scenes that have been likened to “goods on a factory conveyor.”
In fact, some find it almost impossible to see a GP at all, with the ‘8am scramble’ described as the rush to get Glastonbury tickets.
Patient satisfaction has fallen to its lowest level in four decades as a result of the ongoing appointment crisis.
But GP surgeries have also faced increasing harassment, assaults and verbal abuse against staff in recent months.
In May last year, a man was arrested after assaulting a practice in Northamptonshire, where a member of staff required stitches while other attacks were also recorded.
Last week, the government unveiled its long-awaited and highly anticipated long-term NHS staffing plan to tackle chronic staff shortages.
According to her proposals, experienced doctors will also be supported to work in general practice under the supervision of a fully qualified general practitioner.
The number of medical training places will be doubled in 2031/32, bringing the total number of places to 15,000.
GP training places in England for junior doctors will also increase by 50 per cent to 6,000, the NHS promised.
The plan also opens the door to medical internships, with pilots running in 2024/25.