Jeremy Hunt first suggested increasing the GP workforce by 5,000 GPs in 2014, and that target formed part of the Conservatives’ 2015 election manifesto under David Cameron.

While the pledge was omitted from the party’s 2017 election manifesto, the Conservatives later confirmed they were committed to the target.

HOWEVER, according to the latest figures, the number of fully-qualified GPs has continued to fall in spite of increases in trainees.

The General Practice Workforce data up until 30 September 2019 showed that there were 328 FTE additional GPs, including trainees – a rise of 0.9% – compared with September 2018.

BUT, there were 340 fewer fully qualified GPs (excluding registrars) and 489 fewer fully qualified permanent GPs (excluding locums and registrars) over the same period.

IN ADDITION, the number of GP practices also fell by 3.8%, totalling 6,867, suggesting the closure or merger of 270 practices over 12 months.

AND, the figures also show that there were just 297 more nurses (a rise of 1.8%) in the quarter to September 2019 compared with the quarter to September 2018. This led to a record number of vacancies as hospitals sought to recruit for the winter – more than 43,000.

Dr Chaand Nagpaul, British Medical Association council chair, said: “Significant holes in the workforce across areas such as acute medicine and mental health care, particularly in some parts of the country, means that staff are being pushed, often at a detriment to their own health, to make up these shortfalls.

“This is not fair for staff and not fair for patients. The UK falls well below comparable high-income countries in terms of the number of doctors per population (emphasis added) – we do not have to accept this as the norm.

“The Government must do all it can to both retain doctors, including addressing the pension crisis, and ramp up its recruitment efforts by investing in the NHS to make it an attractive career option for doctors and staff from the UK, the EU and internationally.”

Sally Warren, director of policy at The King’s Fund, said the volume and intensity of GP workloads is driving many to either reduce their hours or leave the profession altogether. And although more GPs than ever are being trained, the figures produced by the NHS show that GP numbers continue to decrease, she said.

“Across the country, health and care services are grappling with severe staff shortages,” she continued. “Latest workforce data out today shows there are currently over 105,000 vacancies in NHS trusts, plus 122,000 vacancies in social care at any one time. If the next government wants to deliver on promises to improve health and care services for patients and the public, they must first tackle the workforce crisis.”

Professor Martin Marshall, chair of the Royal College of GPs, described the figures as “disappointing”, adding: “It is serious and we need to see drastic action taken to reverse this trend.”

NHS Digital also produced data for GP appointments, which showed that there were a record 31 million appointments in October – a rise of four million on the previous month.

Dr Richard Vautrey, BMA GP committee chair, said: “The highest number of patients are seen on the day they book their appointment – this speaks volumes to the diligence and commitment of GPs and colleagues in the wider healthcare team.

“Many patients are seen within the following days, and while longer waits are often due to proper planning for long-term care, practices share the frustration of patients when they are unable to always offer appointments sooner.

“This comes on the backdrop of falling GP numbers and the long-term picture is damning, with hundreds fewer full-time equivalent, fully-qualified family doctors than we had this time last year. GP partner numbers are falling at an even faster rate, owing to the additional stresses of owning and running practices.”

So, how did the number of GP appointments go up? The figures are not just for GPs – they will include nurses, healthcare assistants, and practice pharmacists.

Dr Sarah Wollaston, former House of Commons health committee chair and now a Liberal Democrat candidate, added: “People across the country struggling to get appointments will be appalled to see the number of GPs and practices continuing to fall. The Conservatives have completely failed to keep their promise to increase the number of GPs and have now plucked an even greater number out of the air.

“People depend on GP practices for their front-line care. Both patients and the primary care workforce have been badly let down by this government and the situation in general practice will make for a very difficult winter across the NHS.”

Worth noting that Sarah Wollaston was elected as a tory MP in 2010, and only left that party in February of this year … so her criticism is rather opportunist, and not a little hollow!

Hollow too rings the Conservative party’s current ‘pledge’ to increase the number of GPs by 6000 by 2024-25.

Not that I trust any of the other parties to retain GPs and senior consultants who can choose to retire earlier than they intended – as I did. Successive parties have demoralised the workforce, not least by imposing evermore difficult targets that have unforeseen consequences on the system, patients, and clinicians. I don’t think the NHS is safe in any of their hands, but it may now be ripe for hostile USA providers to step in.

Apparently, clinker planking gets its name from a Scandinavian word, clinking – the sound made when iron nails were being hammered in to fix planks to the hull. We use copper nails now, that don’t ‘clink,’ but the etymology is interesting.

Our task, as we move on to ‘Small Boatbuilding’ is to plank up the hulls of the two Deck Boats, finishing at least one, so we can ‘fit out’ the hull with thwarts, and knees (brackets) etc.

Deck Boats like these were one of the smaller, if not the smallest boats ever commissioned by the Royal Navy. Originally from the northern coast of France, and used as fishing boats, the story goes that they found a role in WW2, transporting spies/commandos, and supplies, to and from ships to the shore. They would have been of carvel construction, but clinker is lighter and in keeping with the traditions at the time.

That switch from carvel to clinker brings some considerable difficulties as the turn of the bilge on these boats does not lend itself to clinker construction – as we are finding out!

We are learning a whole new load of terminology: Jerrolds, browing, broddling sticks …; and the associated techniques, including the use of twisted nails.

Of course (!) before putting on more planks, we had to remove some already in place, trying to get a better fit against the transverse moulds. Then, we could start to add new planks. We are supposed to do a practice plank in pairs, then do a test plank for the IBTC Diploma. However, the main goal is to get one of the boats fully planked for ‘fitting out.’

It seems as if it’s a bit of black magic, getting thin strakes to fit tightly against each other in a complex curved shape. How on earth can this be watertight?

The trick is to make the plank/strake fit like a glove, as if flopped on fluidly against there plank below. To get that fit, we use a spiling batten, which readily adopts the required position and shape, and then transfer the shape to a plank, and cut to size. Basically simple, but rather tricky at first.

Once the stock plank is cut to size, reduced in thickness to 9mm, a jerrold (type of joint) is planed in, so that at the bow and stern the planks form a smooth line, rather than a stepped profile.

The planks are steamed to help get them to fit at the bow.

Not in the boxing sense, of course, but an update on our spar-making projects.

After glueing up the four planks to make a 28 ft length, the design of the spar was plotted out by James and Tom who then set to, to mark it out and cut it to size on four faces, before taking it to an octagonal section and then a 16-sided section. After that, the spar was rounded using sandpaper.

A knot in the wood became loose and needed repairing. Tom scalloped out a section to remove the knot and then scarfed in a laminated infil. The end result was superb

Mark and I were given the ‘poisoned chalice’ – a previously-made spar that matched the dimensions for the Victory class racing boats, but was otherwise far too thick for the club’s requirements.

It’s one thing making a square piece of wood round, quite another to thin down a spar with a pear-shaped cross section.

All the time, we had to keep the spar level, and carefully reduce the diameters at key points, then ‘join the dots’ to get it tapered and straight.

The four of us were all thrilled to hear that the Chair of the Victory Class Technical Committee has measured and checked our two masts and passed both as suitable for the club.

No, not mine, but for BB13, the previous cohort to us, who finished in September, and had their Graduation Day on Thursday.

The last graduation, of BB12, had been a bit lame, so the four of us, with James our Student Mentor-cum-Instructor devised some comedy awards, which added some fun to the event.

There is a six month period of overlap, when two cohorts of students are both out on the “shop floor” and it has been great to get to know and work alongside these fellow students.

It was lovely to see them all again, catch up, and give them a good send off. Some have already found work in boatbuilding or other activities – it will be great to keep in touch and follow their progress.

‘Thirsty Thursday’ is a weekly tradition for the IBTC Students so, naturally, the celebrations continued at our usual hostelry, The Ship & Castle!

On Thursday 24th October our group of five students, together with two ex-students and two Instructors, headed west on a ‘jolly.’

First off, we visited Tommy Nielsen’s yard, situated in the historic Gloucester docks.

Everything on Gladys is massive in its scale. This is a major restoration.

Her new decking is Douglas fir. All the seams are being caulked, just as we have done, with caulking hammer and irons, but here with oakum (hemp that has been mixed with tar), for its longevity.

Her hull is getting three layers of oak planking, which are fixed to the original frames, and to each other, with a combination of bolts, spikes and droves. The shortest of these – the six inch droves – are square-sectioned nails. They are driven into pre-drilled holes in the planks with a pneumatic hammer, but have to be finished off with a sledge hammer. Heavy work!

Masses of oak is being used here. Someone commented that it was a waste, given that the ship is to be used for corporate entertainment. In my view, restoring this vessel properly, making her fit for another hundred years, is an end in itself. Also, there are very few outfits in the UK that could do this scale of work, and having these projects is an important part of maintaining the industry’s skills and capacity.

The yard has three main income streams: new build/restoration, rigging, and the film industry, where their skills in rigging classic ships are particularly useful. They send teams around the world to work on projects. Quite an outfit!

After an overnight stay in Bristol, we visited the Underfall yard, which is truly the heart of the Bristol City harbour. Here, there are a collection of boat builders and allied trades, and a massive collection of Victorian machinery for controlling the level of water in the harbour, and maintaining the docks.

As we walked to our next boatyard stop, just 10 minutes away, we passed an open shed, where some people were readying their gig for the next season. Gig racing is most popular in Cornwall and the Scillies, but clubs are taking up the sport elsewhere – including, as we found, in Bristol.

Our last yard visit was to a small two-three man outfit. The owner commented that there had been times when he didn’t know if the business would survive into the next month, and he had diversified into online boat supplies sales, which was helping. Clearly, the business life of small artisanal boatbuilders is a precarious one.

There are some big companies, but not many building in wood. Here, there are opportunities for young apprenticeships. However, apprenticeships are not available or suitable for older entrants to the industry. And, as in many other areas, adverts for shipwright/boatbuilder vacancies ask for evidence of experience.

Thankfully, I am not dependant on finding work in this industry, though I would like to make use of the skills I have learnt. Just as well as, generally speaking, classic boatbuilding job opportunities are limited, and then mainly self-employed/sub-contractor in nature. It was interesting to hear how the couple of ex-students who had joined us on this trip, and who had graduated 18 months ago, were managing to find such work. It’s out there if you’re prepared to seek it out, develop networks, are willing to move about and to be flexible. Not an easy life though – especially for those with commitments.