Government has tried to 'scapegoat' GPs for NHS crisis, say angry GP leaders

GP leaders have slammed attempts to 'scapegoat' GPs for the NHS crisis, after widespread reports that Downing Street sources had blamed GPs for making patients suffer by failing to provide enough access to appointments.

GPC chair Dr Chaand Nagpaul
GPC chair Dr Chaand Nagpaul

GPC chair Dr Chaand Nagpaul said the cause of the crisis engulfing parts of the health service was underfunding, and warned this was 'not the time to deflect blame or scapegoat overstretched GP services'.

Conservative MP and former GP Dr Sarah Wollaston called comments attributed to Downing Street 'beyond belief'.

Reports over the weekend suggested that some practice funding could in future be linked to the requirement to open from 8am to 8pm, seven days a week unless they can prove there is no local demand.

GP access

The Guardian quoted a Downing Street source as saying: ‘Most GPs do a fantastic job and have their patients’ interests firmly at heart. However, it is increasingly clear that a large number of surgeries are not providing access that patients need – and that patients are suffering as a result, because they are then forced to go to A&E to seek care. It’s also bad for hospitals, who then face additional pressure on their services.’

Reports said Downing Street believes practices are failling to provide extended access, despite the government's election manifesto promise that all patients will have access to seven-day GP services by 2020.

But health ministers have repeatedly made clear that the policy would not require every practice to provide extended access, which could be provided by groups of practices or hubs.

The GP Forward View published in April announced £500m of recurrent funding to be allocated to CCGs by 2020/21 to fund enhanced access schemes, building on the existing access pilots funded from the £175m prime minister’s Challenge/GP Access Fund, which launched in 2014 and now covers a third of England's population.

A report by the government auditor last week said the NHS had failed to consider fully the consequences and cost-effectiveness of plans to roll out seven-day GP services. NHS England's own evaluations of the pilots have found little demand for routine Sunday appointments.

Extended hours

In October NHS England said that it would begin ranking practices publicly on the level of extended hours access they provide.

Dr Nagpaul said: ‘The current crisis in the health service extends well beyond A&Es, with all parts of the NHS, including GP surgeries, working as hard as they possibly and safely can to keep up with demand. Much of the pressure on A&E has nothing to do with general practice: it has to do with seriously ill patients for whom seeing a GP would not prevent a hospital admission.

'These patients are facing delays in being admitted to hospital because of a chronic shortage of beds, as well as delays in discharging elderly patients due to a funding crisis in community and social care. This crisis, which was both predictable and avoidable, is the culmination of a decade of underfunding, and a recruitment crisis that has left one in three GP practices unable to fill vacancies.

He added: ‘This is not the time to deflect blame or scapegoat overstretched GP services, when the fundamental cause of this crisis is that funding is not keeping up with demand.’ This is evidenced by the fact the UK spends less on health and has fewer doctors and beds per head than other leading countries, as highlighted by the head of NHS England, Simon Stevens, only this week.

'Rather than trying to shamelessly shift the blame onto GPs, the government should take responsibility for a crisis of its own making and outline an emergency plan to get to grips with the underlying cause, which is the chronic under-resourcing of the NHS and social care.’

GP opening hours

RCGP chair professor Helen Stokes-Lampard said: ‘It is not the case that GP surgery routine opening hours are contributing to the pressures our colleagues in A&E departments are currently facing. GPs and our teams are also struggling to cope with increasing patient demand without enough investment, and without nearly enough family doctors and practice staff to deal with it - this is a year-long problem for us, not just during the winter.’

‘It has never made sense to force GPs to offer services that there is little patient demand for. In many cases practices have already had to actually stop offering extended opening hours because of a lack of patient demand for them.’

The GP Survival group called on the medical profession and the public to ‘stand up to the government’s outrageous attempt to blame GPs for the current crisis in hospital and A&E services’.

‘This attempt by the prime minister and the health secretary to blame underfunded and beleaguered GP services and now patients for the crisis in A&E services shows a desperate attempt by the government to shift responsibility and blame for the mishandling of the NHS to the medical profession and the public.’

Conservative health select committee chair and former GP Dr Sarah Wollaston MP said on Twitter it was ‘beyond belief that anyone would think that attacking an overstretched and demoralised primary care would serve any purpose whatsoever’.

BMA deputy chair and GPC member Dr David Wrigley said the prime minister was ‘actually asking doctors to provide unsafe care to their patients which goes against everything a doctor has been trained for’.

‘GPs work 12-14 hours a day in an NHS collapsing around them due to the defunding of the NHS by this government and cuts to social care brought about by Theresa May and her cabinet.

‘Shamefully for this government our NHS is one of the lowest funded health services compared with other European countries. We are short of thousands of GPs in this country.

‘This government constantly parades the fact there are "thousands of extra doctors" but this is just not evident and shows how out of touch this government is. GPs cannot currently provide safe care in their surgeries Monday to Friday so asking them to open seven days a week verges on the dangerous.’

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