Ill patients reject sick notes from their GP because they cannot afford to take time off work, while doctors suffer “moral anguish” at their powerlessness to do more to help the most vulnerable, the new leader revealed of Great Britain’s family doctors.
More patients are experiencing asthma attacks or other serious respiratory problems because they can’t afford to heat their homes, said Dr. Kamila Hawthorne, president of the Royal College of GPSwhile many have reported a decline in mental health due to financial stress.
Rising food costs are also leading to increased fatigue, canker sores and weak muscles, and people are starved of key vitamins because they can’t afford to eat anything other than a poor diet. .
Many patients present with complex physical and psychological problems related to poverty, domestic violence, child abuse or poor housing that GPs suffer psychologically from their inability to take necessary action, he said.
Hawthorne, a GP in the Welsh valleys, warned that illnesses linked to increasing pressures on household budgets would also put even greater pressure on already overburdened family medical services.
It comes as leading physicians have warned that more GPs are leaving the profession than are entering it, and Hawthorne said new trainees entering the profession “will not be enough” to meet growing healthcare needs.
Hawthorne said: “Lately I’ve had patients turn down sick notes because they can’t afford not to work. Very often, when it’s clear someone needs time off, they won’t take it.
“These are people who ideally, medically, should not be at work. [because] have a chronic condition like asthma or diabetes, but very often mental health problems, quite severe mental health problems, I [see] some cases that really require some peace and quiet to try and help them get better.
“I’ve been really surprised in the last year that when I’ve offered sick leave they’ve said, ‘Oh no, no, I can’t take time off. I need the money from work. They have refused. They say: ‘I need to keep working to earn and feed myself and my family.’ I don’t take it personally, of course, but I feel sorry for people because for a few minutes you enter their lives and see how difficult it is.”
Those turning down sick notes are mainly young and middle-aged adults, including people who work in call centers, but it’s also seen in people with young families and older people, Hawthorne said.
Skyrocketing food and energy prices have left some patients unable to pay for transport to appointments at the GP practice she and her colleagues run near Pontypridd, or even to hospital for receive a pre-booked treatment.
His comments came as Rishi Sunak warned that this winter was going to be “challenging” for the UK as a result of rapidly rising prices, strikes and long waits for National Health Service watch out.
The prime minister told the cabinet at their weekly meeting on Tuesday that the coming months would bring widespread misery as they discussed how to ease the crisis. A No 10 spokesperson said: “Looking ahead to winter, the prime minister said this would be a challenging period for the country caused by aftershocks from the global pandemic and the ongoing conflict in Ukraine.”
The coming cold snap will further worsen the health and well-being of patients, Hawthorne fears. “The cost of living crisis has been there for a long time. But suddenly it got a lot worse in the last few months. Now I have patients who are worried about fuel costs this winter, who haven’t turned on the heat yet and are keeping the windows closed.
“People are very, very anxious about what is to come and whether they will have to choose between heating and eating.
“The moral anguish among doctors comes from not being able to do more [to help people with complex problems]. We can help most people who come to see us if they have, for example, a rash, menstrual problems or anxiety and depression. However, more and more, we are seeing people with intractable social and psychological problems that are very difficult to resolve,” she said.
She added: “Some people have really horrible stories. GPs are trained to help triage people. But when we as family doctors are faced with one intractable problem after another problem after another, that can be quite exhausting to watch.
“That feeling of hopelessness that the patient brings with them is transferred to you as the GP. When it’s patient after patient after patient, you really go home at the end of the day feeling like a squeezed lemon. It’s pretty tiring.”
GPs are also distraught to see patients’ health worsen because they have been stuck for so long in the NHS. waiting lists, she added. “It’s particularly the people with pain in their hips and knees, the people who now crawl up the stairs, because they can’t go up anymore and the only bathroom is upstairs.”
Hawthorne said he had also noticed an increase in folate deficiency, a lack of B vitamins in some patients, caused by a poor diet precipitated by poverty. He urged ministers to spend more on energy and food vouchers for the most vulnerable patients.
Expanding eligibility for free school meals would also help alleviate the dire situation some families found themselves in.
Hawthorne also criticized ministers for “bashing GPs” and their recent promise that patients could see a GP within two weeks, and in the day if it is urgent, which she said she was ignorant of the underlying problems. “Ministers must know that this policy is impossible to comply with. The number of GPs is falling and the number of patients we are seeing is increasing. Being a family doctor is becoming untenable, impractical, unfeasible. The routine is such that people retire as fast as they can.
“Insisting on this two-week rule, when they know access to GPs is a problem, will actually make the problem worse.”
In 2022, 4,032 trainee GPs were accepted on traineeships, according to new figures published by Health Education England. Hawthorne said she was “encouraged” by the number of new recruits, but cautioned that “it won’t be enough to meet current or future health care needs.” The Royal College has estimated that up to 19,000 doctors could leave the profession in the next five years due to workload pressures.
A government spokesperson said: “We value the hard work of GPs and are doing everything we can to support them and patients in these difficult times, including prioritizing the NHS with an additional £6.6 billion, on top of funding. previous record, in the fall statement.
“We remain committed to growing the GP workforce and there were nearly 2,300 more full-time equivalent physicians working in general practice in September 2022 compared to the same period in 2019, while a record number accepted a position. GP training last year.