BRITAIN'S "OVERSTRETCHED" NATIONAL HEALTH

A system in trouble

South African doctors have become the latest long- distance recruits to join Britain's overstretched GP workforce. Riaan Vlok, a family doctor from South Africa's North West Province, said that the benefits on offer in Britain were such that he had decided to abandon private practice in his homeland for locum work on the NHS. Dr Vlok, 49, is part of a growing foreign workforce brought in to help to support primary care services as more British GPs give up out-of-hours work and the profession struggles to attract junior doctors to general practice.

Health recruitment agencies in rural South Africa said that the number of doctors expressing an interest in working in Britain had risen sharply in recent months as word got round on how much they could earn. The influx follows the recruitment of GPs from Germany and Polish dentists. On GPNet, a website directory of family doctors in South Africa, advertisements offer doctors 7,300 pounds to work for a month or 16,000 pounds for ten weeks' work. Other attractions offered include free flights, a "meet and greet" on arrival in Britain and the chance to travel around Europe.

Dr Vlok now spends a month at a time working as GP cover in surgeries in Mansfield and Ashfield in Nottinghamshire. He returns home for a fortnight's holiday every four weeks. He said that although the hours could be long and the climate less agreeable, he enjoyed the contrast of British life with that on his ranch near Pretoria, where he lives with his wife and son. "I love my job," he said. "It is like night and day. A change is as good as a holiday."

While family doctors in South Africa earn similar salaries to those in Britain - around 75,000 pounds a year - the hourly locum rate is much higher and comes without the overheads of running a surgery. Dr Vlok said that he was paid 200 pounds for seeing 16 patients in a two-hour session and he normally worked about 12 sessions each week, earning 2,400 pounds. "It is similar to South Africa," said Dr Vlok, who practised in his homeland for 18 years. "But here I keep what I make and walk out. I can make more money as a temporary GP here than operating a private practice back home."

John Howard, chairman of the Royal College of GPs International Committee, said that hiring from abroad did not address the essential problem. "With a current shortage of GPs the profession is placed in the position of having to recruit from abroad," he said. "We understand GPs from South Africa are recruited and feel this is unfortunate as South Africa, along with other African countries, does need its doctors. We would like to see more doctors in the UK training to be GPs."

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AND AN EXPERIENCE FROM THE HEART OF THE ENGLISH BEAST

Spear Shaker emails me as follows:

John, I felt the need to rant. I realize that everyone can cite a horror-story, but in this case it hits home. My father-in-law, living in Oxfordshire, has had the following NHS service over the last year:

When diagnosed with a Brain Tumor, was put on a 10-month long NHS waiting list to get the appropriate tests. Since his balance was being impaired by the tumor, he had to pay for private testing, diagnosis, and ultimately surgery to arrest its growth, rather than wait for it to grow and metastasize.

When diagnosed with severe angina and a potential arterial blockage, he was put on a 6-month long waiting list to get an angiogram. He was then prescribed the wrong medication (in lieu of tests) which almost caused him to die, lowering his heart rate to 36 beats per minute and requiring an ambulance/emergency room visit. Instead of waiting the 6 months, he is now paying for a private angiogram.

How can this system continue? Brain tumors and heart pains are elective conditions. I am stunned that the Brits just keep taking it. . .

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

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