He explained that “some radical way” will have to be found to increase funding or to decrease costs
Derry-based doctor, Tom Black, said the Department of Health (DoH) was supposed to provide GP practices with a 6% uplift in funding to meet the needs of patients which still would have been “inadequate”.
Last week, the Permanent Secretary at the Department of Health, Peter May, said the health service is currently facing unfunded spending pressures of £472m, of which £375m relates to a staff pay claim matching NHS England.
At the same time inflation has meant day-to-day costs such as electricity, fuel and labour has risen.
Dr Black said Abbey Medical Practice has been running a deficit for the last year and needed an overdraft extended for three months.
Beyond that, a five-figure sum will be offered in a loan and have to be guaranteed against a house.
“In six months we’d be bankrupt,” he said. “I shouldn’t use the word bankrupt as doctors don’t go bankrupt, because if you do, your name is likely to be removed from the General Medical Council register — so what we would have to do is take out second mortgages on our homes.”
Dr Black explained that “some radical way” will have to be found to increase funding or to decrease costs. He added: “That has to be done in the next month or two if we’re going to be sustainable over the medium term.”
The practice has already lost one doctor which has increased the workload for others.
Likewise, if a receptionist loses a job then the other receptionists are forced to work harder.
Closing a treatment room, he explained, would not be fair on patients as they would have to go to hospital for dressings and blood tests. Dr Black was keen to stress that GP practices across NI are facing the same pressures and difficult choices.
“The word ‘bankruptcy’ is mentioned a lot at doctors’ meetings now. And the number of GP practices must be approaching 19 or 20 at this stage that have handed their contract back because the fastest way to solve this problem is to hand the contract back and just say, ‘we can’t make this work’.”
Waiting lists are so long at the moment that it has increased GP workloads by about 30% to 40%, according to Dr Black.
Patients waiting for a hip replacement, for example, have to visit their GP more often for pain killers or examinations.
In deprived areas, such as the one he is based in the Bogside area of Derry, many patients do not have the option of going private for such treatments as they do in more affluent areas.
Recruitment is also difficult, the BMA chair said, as doctors are opting for better pay across the border in places like Buncrana, Moville and Lifford.
Of up to 20 practices that have been taken over, Dr Black said they cost “about 30% more” for Health Trusts or other organisations to run which means “they’re short-changing us by about 30% in terms of funding”.
Dr Black added: “So it becomes much more expensive to the health service. And of course the corollary of that of course is, less money for the practices that are still being run by GP partners.
“And that seems to be a big part of this problem, if the health service is spending lots of extra money on collapsed practices then there’s less money available for the practices run by GP partners. We think this is at the back of a lot of this.”
Doctor Black said it isn’t about his own personal situation or complaining that he’s badly paid as he could choose to retire at this stage of his career.
But he doesn’t want to see Abbey Medical Practice, which has existed for 100 years, lost for people living in an area of “high deprivation” — one in which his father and grandfather were patients so is “determined to keep it open”.
Dr Black said staff will be called to a meeting tomorrow where they will be reassured that no jobs will be lost. If Stormont was functioning Dr Black believes the 6% uplift would be applied which would provide a cushion for struggling GP practices.
A spokesperson for the DoH said it is committed to ensuring that patients will be able to continue to access high quality, sustainable GP services “now and in the future”.