Editorial: NHS cash still short whoever wins the election

Do you understand how bad the NHS's financial situation is?

In this week's GP, RCGP chairman Professor Steve Field explains that people see the £15 billion shortfall in funding but do not grasp the scale of change needed and what this means for individual GPs.

Last week the DoH published its consultation on abolishing practice boundaries. Radical proposals include dual registration and requiring GPs to arrange home visits for all patients, regardless of where they live under these new arrangements.

Jim Easton, the DoH's national director for improvement and efficiency in England, explains that the government's emphasis is on quality and that 'huge opportunities'

exist for GPs. He acknowledges that primary care is already the 'keystone' of the system and it remains essential as care is shifted from hospitals.

As ever, there are two ways of looking at this insistence on change: is your glass half full or half empty?

The abolition of practice boundaries could lead to practices run by private firms cherry-picking the young and fit, leaving the rest of traditional general practice to cope with a more demanding and less profitable elderly population.

Or change could be minimal, as the DoH and RCGP predict.

Equally, the change required by the NHS of GPs could present your practice with 'huge opportunities' or a big headache.

The Conservatives actually proposed the abolition of practice boundaries some years ago and, whichever government is in power after the forthcoming election, that £15 billion NHS shortfall is not going away.

GP newspaper has always been quick to champion both the value of general practice and the entrepreneurial flair of those at its heart.

The DoH appears to have thrown down the gauntlet with the added threat of private firms waiting in the wings to spur practices into action. GP has every confidence that you can meet the challenge.

Listen to Professor Field's opinions in our exclusive podcast

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