STRESS AND MORALE IN GENERAL-PRACTICE - A COMPARISON OF 2 HEALTH-CARESYSTEMS

Background. Poor morale and high levels of stress among general practi tioners (GPs) are causing concern. Little research has previously been carried our to study possible differences in morale and stress betwee n GPs working in two different but geographically similar health care systems. Aim. To compare perceived levels of stress and morale between GPs working in two different health care systems - one having a state monopoly (Northern Ireland) and the other having mixed private and st ate funding (Republic of Ireland) - and to look for factors that might help explain any differences in stress levels and morale between the two systems. Method. Anonymous and confidential questionnaires were se nt to all 986 National Health Service (NHS) GPs in Northern Ireland (N I) and a random sample of 900 GPs in the Republic of Ireland (ROI). A common set of core questions on demographic details, partners and work patterns, perceived levels of stress and morale, safety, violence, an d complaints were asked. Results. Response rates were high in both are as: 91% in NI and 78% in the ROI. GPs in NI had significantly higher s tress levels and significantly lower levels of morale than GPs in the ROI. The NI sample expect matters to get worse over the following year . Doctors in the ROI were more likely to be single handed and to work from two sites. Also, more GPs in ROI had fears for their safety and h ad been the subject of physical violence, but fewer had received compl aints and medico-legal actions than in NI. Conclusions. A significant proportion of both groups of doctors report feeling highly stressed bu t GPs in NI appear more unhappy and have a poorer outlook for the futu re. It is suggested that the structure, management, and expectations o f the NHS have taken a severe toll on its GPs, whereas a system in whi ch doctors have less practice support but more control is good for mor ale.