‘Golden Hello’ plan for doctors raises questions
The proposal by Health Secretary Jeremy Hunt to give young GPs in training a ‘golden hello’ one-off payment of £20,000 if they agree to work in rural areas has a superficial appeal as a way of tackling the crisis in family doctor practices in remote places.
Northern Ireland, like England and Wales, has seen an increasing demand for GP services from an ageing population — up by more than 60% in 10 years — and a number of practices, particularly in rural areas of Co Fermanagh, have closed, leaving people to make lengthy round trips to seek medical opinion and also lengthy waiting times for appointments.
A significant proportion of the GP population in the province is nearing retirement age and there are fears that younger GPs will be reluctant to move to the more rural practices.
It is against that backdrop that the BMA in the province is urging the Health Secretary to extend the proposed scheme across the Irish Sea.
But it is a move which might not be widely appreciated by the public, who feel that the level of service provided by family doctors has declined in recent years. GPs increasingly decline to work weekends or at night or make house calls, except in emergencies. The slack is taken up by out-of-hour services.
In the public mind doctors are members of a caring profession — and while they are independent contractors are still seen as an integral part of the NHS. They are well rewarded for their work — although it is difficult to put a price on a person who could one day save your life.
The public will wonder if there is not a better way to organise GP services than by what could be seen as a bribe to young members of the professions to move to the countryside.
After all, Northern Ireland is a largely rural area, so the demand for the proposed windfall could be high at a time when the health service is already suffering a cash crisis.
Surely it would be better to ensure that sufficient training posts for GPs are in position and that new working practices are introduced?
It has not escaped the notice of the public that an element of market forces has entered this sector of healthcare. Locums are routinely paid £360 a day for covering for GPs in Belfast — even more in rural areas. At those rates the £20,000 one-off payment may not have great appeal to doctors, but may jar with their patients.