The government promised to put general practice at the heart of the NHS but has instead presided over a collapse of morale. Their reorganisation has been a failure on its own terms. Ministers must stop GP-bashing and accept responsibility for the growing crisis of their making.
From within a flat NHS budget, the government decided to prioritise a £3 billion back-office, structural reorganisation. That money has had to come from somewhere and the GP budget has been one of the prime casualties. The abrupt phasing-out of MPIG too has left the finances of many practices on a knife-edge, some on the brink of closure. Practices are under-staffed and over-stretched and patients are, unsurprisingly, finding it harder to get appointments.
GPs are turning away
I have heard stories of many experienced GPs becoming so fed up with the way things are that they have taken early retirement. At the other end, medical students see the pressure and the chaos and are turning away from a profession that no longer appears an attractive career option. The 2004 GP contract was by no means perfect but some of the problems it successfully tackled are now returning with a vengeance.
Labour increased the number of GPs to record levels, but things are slipping back. We know we can’t improve access without more GPs, especially in areas of the country with shortages. That’s why GP recruitment will be a priority for the next government - from better promotion of general practice as a career choice to finding new ways of working, and new models of integrated care, that might better suit the next generation of GPs.
Labour believes the cuts are a false economy. If we want to build a truly preventative and cost-effective NHS, then we have to invest in the best possible access to care at community level. People now struggling to see their GP only turn to much more expensive A&E departments.
Labour plans access overhaul
The next Labour government will ensure the pendulum swings back towards early intervention and primary care. This is essential if we are to realise our vision of 'whole person care' and the full integration of health and social care. We will start by investing £100 million to improve access and give patients a range of options: a same-day consultation – either a telephone consultation with a doctor or nurse, or a same-day appointment if it’s urgent; an appointment with a GP within 48 hours if clinically necessary; or the right to book more than 48 hours ahead with the GP or primary care professional of your choice.
Labour will pay for the extra investment by removing the wasteful competition framework that the government has put in place, which many commissioners say is forcing them to put services out to tender and hindering service improvements.
It’s not about a one-size-fits-all approach; it will be for surgeries themselves to determine how to use the extra funds. Over the next six months we will be talking with the profession about the best way to make this extra investment work best. But, more broadly, we will be working closely with the profession to develop a shared vision of how a fully integrated NHS might work and a realistic journey to get us there.