In his keynote speech to the 2017 LMCs conference in Edinburgh, Dr Nagpaul is expected to hit out at politicians' 'callous disregard for the NHS'.
The BMA's GP leader will tell LMC representatives that the NHS has been 'paralysed' by Brexit - cheated with a 'deep freeze on NHS spend' and 'savage austerity cuts' instead of the £350m per week windfall promised during the referendum campaign.
Just weeks ahead of the 8 June general election, the GPC chair will accuse politicians of 'turning a blind eye' to spiralling pressures facing health and social care. GPs, Dr Nagpaul will say, must 'stake our claim with our patients and the public to demand that the general election delivers a government that will fund the NHS properly'.
Despite extra funding delivered through the 2017/18 GP contract deal and pledges set out in the GP Forward View, Dr Nagpaul will tell LMCs that the profession remains in a parlous state and on the brink of collapse, with thousands of practices unable to recruit and many warning they are struggling to remain financially viable.
He will tell the conference: 'Far from the pledged investment of an extra £350m per week, audaciously plastered on double decker buses, the reality is we’ve been cheated with the opposite: a deep freeze in NHS spend, continued savage austerity cuts and with politicians turning a blind eye to the spiralling pressures affecting the entire health and social care system, in which even the 18-week target, laid down in the NHS constitution, is being allowed to be breached.
'Despite these straitjackets, the GPC has worked hard to deliver change for the profession. We secured NHS England's acceptance that they will take forward our Urgent Prescription for General Practice. This paved the way for our 2017/18 contract negotiations, in which we secured an end to the avoiding unplanned admission enhanced service, with the entire £157m put into core funding, and practices were set free from the bureaucracy of chasing futile statistics of care plans.'
Dr Nagpaul will highlight deals struck by the GPC to protect practices from CQC costs and rising indemnity fees, and improved sickness cover arrangements.
But he will add: 'Despite these contract improvements, the plight of general practice remains parlous and on the brink of collapse. We’ve always been clear the crisis in general practice cannot be addressed by these annual contract revisions.'
Just weeks after GPonline revealed that GP practices across England are continuing to deliver enhanced services worth millions of pounds for free, Dr Nagpaul will hit out at 'the avalanche of work piling up from outside our contract, which is either inappropriate or unresourced'.
'We have a service that is several thousand GPs short due to shambolic workforce planning a decade ago,' the GPC chair will warn. 'We’re in effect paying the price of disinvestment in general practice at a time of plenty, and are now trying to make up for it at a time of empty.
'There’s sadly no fat in other parts of the system to transfer to general practice, with a financial crisis spanning community, hospital and social care all of which adds more work onto general practice. The real solution is a political one – in which politicians must end their callous disregard of the health needs of citizens in an NHS that shamefully trails Europe in its funding, numbers of doctors and infrastructure.
'The only solution is for government to increase NHS funding to adequate levels, in which general practice receives a fair and larger share. That’s what voters need to demand from the coming general election, and why investment in general practice is one of the five key asks in the BMA election manifesto.'
On the GP Forward View, Dr Nagpaul will say: 'We know it won’t in itself solve the crisis in general practice, and it’s not an adequate funding package within a bankrupt NHS. However it’s our duty to hold NHS England to account to ensure that this vital, promised funding reaches GP practices and is not squandered; that £2.4bn is actually recurrently delivered by 2021, and that the £508m allocated for the transformation fund is actually spent to support practices that need it desperately.
He will highlight the increasing vulnerability of practices, warning that 'even a seemingly secure practice is just one partner away from retiring to set off a domino effect' that could lead to collapse.
Dr Nagpaul will say: 'Like before, we can – we must – get through these troubled times, with confidence and self-belief that the service we provide to 1m patients daily trounces all the empty promises of politicians. In which even recent surveys shows that patients continue to trust GPs at the highest of levels, despite our constraints.
'We must therefore resurrect our Darwinian survival instinct, and stake our claim with our patients and the public to demand that the general election delivers a government that will fund the NHS properly – to bring spending on our health service in line with other European countries, plugging the enormous funding gap – and give general practice the resources to do justice to our profession, our discipline and the patients we care for.'