Jeremy Hunt interview: 'I am GPs' biggest fan'

Health secretary Jeremy Hunt is full of praise for GPs, but wants to see a return to more personalised care. Marina Soteriou reports.

Jeremy Hunt has not exactly hit it off with GPs since he became health secretary 11 months ago.

Just over a month after making the switch from culture secretary to replace Andrew Lansley, he signed off and imposed deeply unpopular changes to the 2013/14 GMS contract when talks broke down.

His recent comments about 'taking on the GP contract' in the out-of-hours row were seen by many as a criticism of the profession.

But in an exclusive interview with GP magazine at his Whitehall office, Mr Hunt is keen to make amends with GPs, who he claims he 'took great trouble' not to offend.

'I am the biggest fan of GPs,' he says. 'I really am.'

'I think that one of the biggest strengths of the NHS is our strong tradition of primary care and general practice is at the heart of that.'

Sitting next to framed photographs of him meeting former governor of California Arnold Schwarzenegger and the former Pope Benedict, Mr Hunt is keen to emphasise his commitment to, and willingness to invest in, the profession.

Profile - Jeremy Hunt
  • May 2005 Conservative MP for South West Surrey
  • December 2005 Shadow minister for disabled people
  • July 2007 Shadow secretary, culture, media and sport
  • May 2010 Secretary of state, culture, Olympics, media and sport
  • September 2012 Health secretary.

Charm offensive

'We definitely need to increase the amount of resource going into primary care, we definitely need to increase the capacity of primary care and we definitely need to increase the number of GPs, without doubt.'

He is predictably light on detail when asked how the government will achieve this.

'We have protected the NHS budget, which has meant that other government departments have had much bigger cuts,' he says.

Critics, of course, say protection of the NHS budget has added up to real-terms cuts. But Mr Hunt says he is determined to make sure that resources follow patients out of hospital settings, 'something that has eluded governments for many, many years'.

He adds: 'Unless we invest in primary care, unless we invest in what GPs can deliver in terms of being the linchpin of joined up, integrated services for vulnerable older people, then we are never going to make the NHS sustainable.'

Personalised care

He acknowledges that GP workload levels are high and is adamant that he is not asking them to do more.

But he does want them to return to delivering more 'personalised' care.

'I think most GPs in their hearts find it difficult to deliver the personalised care they would like to,' he says.

He wants GPs to take a more 'pro-active' role in the care of the vulnerable elderly, which he hopes will create efficiencies across the whole of the NHS, because they are the people who use it most.

GPs in England could soon be facing this extra responsibility. A DH consultation on making GPs the named clinicians accountable for the care of vulnerable older people after they leave hospital will be completed on 27 September.

'In some ways, GP surgeries beat to the same rhythm as A&E,' he says. 'We have crowded out the possibility of actually checking up on somebody who may have been discharged from hospital that day or who you know has a complex long-term condition and may be vulnerable.

'That is why I think we need to ask whether we can do something to rediscover the traditional role of a family doctor in a modern context.'

GP contract

He wants his legacy to be a 'transformation in the role of GPs', to free them up to spend longer with their older, vulnerable patients and to ease the bureaucracy they face.

One vehicle he has in his sights to liberate GPs from bureaucracy is their contract.

'I wouldn't want those changes to the GP contract (made this year) to be the last word because I think that we need a more fundamental rethink about whether that GP contract is achieving things it was set out to achieve in 2004 and whether it allows GPs to have that personal relationship with people on their list that I think is at the heart of what general practice is about.'

He acknowledges that box ticking and targets for GPs have risen under his leadership and admits that it is 'something we need to look at'.

He says he would be 'incredibly proud' if his legacy was to 'create structures' that allowed GPs to return to having the time for personalised care.

'The structures we have created, the QOF, the DES, the LES, make it really difficult for GPs to have that personal relationship and to have the time to spend proactively thinking about the most vulnerable people on their lists and what they need.'

Out-of-hours

GPs are still nervous about the looming changes to out-of-hours that are in the pipeline for England.

But Mr Hunt reassures GPs that any changes will not result in a return to them having 24-hour responsibility for all patients on their lists.

'I don't think we can go back to GPs being on call at weekends, they have families, they work very hard and I recognise those days are gone.

'But I would like to see GPs taking more responsibility, particularly for the frail elderly, the most vulnerable people on their lists and for making sure they are able to access care in an urgent or emergency situation out-of-hours.

'How we do that is something we need to discuss and may involve changes to the GP contract.'

He defends his remarks about the 2004 GP contract being responsible for rising pressures on A&E. 'The last thing it was, was a criticism of the profession,' he argues.

'I took great trouble to say that I think GPs work very hard, they have very long days and I think they have a very pressured job.

'This is not about asking GPs to work harder because I don't think they have the capacity to do that.'

Investment

'This government has done a lot for GPs and we will do more,' he says, pointing to the decision to set up GP-led CCGs as evidence of this.

'It is a huge misconception to characterise this government as anything other than strongly supporting the role of GPs.'

Many GPs will struggle to agree with that. But the real test of the extent to which Mr Hunt is GPs' biggest fan could come later this year, when talks on the 2014/15 GP contract commence.

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