GPs in the early years of the NHS struggled with 80 patients a day, three times the ‘safe’ limit

There has been no shortage of patients sharing shocking stories of how the lack of face-to-face appointments or being stuck in the endless maze of phone calls and online forms has harmed their health.

And GP practices themselves have detailed disturbing stories of overwhelming and dangerous workloads and increasing levels of staff abuse in recent years.

Against this backdrop of the struggling primary care sector, the NHS celebrated its 75th anniversary today.

But records have revealed that the 1950s, shortly after the health service was founded, was an equally challenging period for general practice, with GPs forced to treat up to 80 patients in a single day.

A 30-page report published in The Lancet in 1950 concluded that “the general state of general medicine in England is bad and continues to deteriorate.”

Written by Australian GP Joseph Collings, the highly critical report also judged inner-city practices “at best…highly unsatisfactory and at worst a positive source of public danger.” .

Meanwhile, the practice rooms were “dirty and poorly equipped” with “rusty and dusty old instruments,” he said.

The report drew an angry response from the profession at the time, considered unfair by many.

But Dr Collings pointed out that GPs themselves were not to blame, noting, in a statement 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 must result in the elimination of general practice as an effective health care agency,” he wrote.

Similarly, in his report ‘General Method and Primary Health Care 1940 to 1980’, Dr John Fry, a founder member of the Royal College of General Practitioners, detailed his experience working as a GP when the NHS was founded. .

“The maximum number of patients allowed for a director in general practice was 4,500,” he wrote.

“Within a few weeks he had over 3,000 patients registered with the NHS,” he added.

‘The initial euphoria in the NHS was short-lived. The 1950s became a period of criticism and counterattack on many aspects of general practice,” he said.

Research published in the BMJ in 2006 also revealed that GPs in the 1950s “were overwhelmed with demands from their patients in the early years of the NHS”.

He added: “The idealism that led many GPs to work 24 hours a day led to a drop in both morale and standards.”

Between 1947 and 1950, the average number of times a patient saw their GP rose from 4.8 a year in 1947 to 5.6 in 1950, he said.

In 1953, it was also estimated that GPs made between 12 and 30 daily home visits, while also seeing between 15 and 50 patients in their surgeries.

According to recommendations implemented by the BMA and the European Union of General Practitioners, today’s doctors should not make more than 25 appointments a day to ensure “safe care”.

But some doctors are reportedly having to see nearly 60 patients a day in some areas amid an appointment crisis.

GPs say their surgeries are overwhelmed by the pressures of an increasing and aging population, a lack of government funding and a shortage of doctors. NHS statistics show there were 27,231 full-time equivalent fully qualified GPs working in the NHS in England, as of April 2023. Full-time equivalent terms equate to 37.5 hours a week

Leading experts said today that the MailOnline research illustrates how the general practice is a ‘rubber band stretched to breaking point’. Graph shows proportion of GP patients per practice since 2015, averaging 9,755 patients per surgery in May 2023

Exactly why Brits are still struggling to get a GP appointment is complicated.

Nationwide, the doctor-patient relationship now stands at an average of 2,292, nearly a fifth higher than in 2015.

Ministers have also quietly scrapped a promise to hire 6,000 more GPs, which was an important part of Boris Johnson’s election-winning manifesto.

Only 2,000 more family doctors have been hired since 2019.

But the number of fully qualified GPs, who work the full-time equivalent of 37.5 hours on average per week, has dropped to around 27,300, the data shows.

Analysts believe another 7,400 are still needed to fill the gaps.

Making the staffing crisis worse is the fact that many current GPs are retiring at 50, moving abroad or going to work in the private sector due to growing demand, NHS red tape and aggressive media coverage.

Another factor is that as the number of GPs has shrunk, the overall population has grown, meaning there are fewer GPs to go around.

The result is millions of patients rushing to their appointments, in scenes that have been compared to “goods on a factory conveyor belt.”

Some even find it almost impossible to watch a GP in the first place, with the ‘8am scramble’ being described as the rush to get Glastonbury tickets.

Patient satisfaction, as a result of the never-ending dating crisis, has plummeted to its lowest level in four decades.

But GP surgeries have also faced increasing levels of harassment, assault and verbal abuse directed at staff in recent months.

In May last year, a man was arrested after attacking a practice in Northamptonshire, leaving a staff member requiring stitches and other attacks were also reported.

Last week, the government unveiled its long-awaited and anticipated NHS long-term workforce plan to help tackle chronic staff shortages.

Under their proposals, experienced doctors will also be supported to work in general practice under the supervision of a fully qualified GP.

The number of training places in medical schools will double by 2031/32, bringing the total number of places to 15,000.

General practitioner training places in England for young doctors will also increase by 50 percent to 6,000, the NHS has promised.

The plan also opens the door for medical-grade apprenticeships, with pilots running in 2024/25.