Viewpoint: Dr Kailash Chand: Increase general practice spend to 11% of NHS budget

The pressures facing general practice received a prominent platform in a front page article in today's Guardian: Life of a GP: 'We are crumbling under the pressures of workload'.

Dr Chand: 'All major political parties must pledge before the election to increase investment in general practice.' Pic: Michele Jones
Dr Chand: 'All major political parties must pledge before the election to increase investment in general practice.' Pic: Michele Jones

Almost all GPs can relate to what Dr Veena Jha told the Guardian that being a GP is exciting, diverse and challenging and more people need to understand that.

No-one can withstand the pressures GPs are now under and there is no prospect of any let up. Each GP is handling 1,500 more consultations a year than in 2008 with substantially reduced resources. GPs and practice nurses can’t keep doing more for less and now that funding for general practice in England has slumped to just 8.5% of the NHS budget the service we provide is in crisis. To make things worse, the unprecedented decline in funding for healthcare in the community has brought general practice to its knees. The government is increasingly asking GP practices to provide more services, including many involving the transfer of hospital care into the community, without the resources required to successfully deliver them.

Serious workforce crisis in general practice very soon

It is obvious from the GPs interviewed by the Guardian that general practice is facing a workload disaster that is threatening its long-term future. More than a third of GPs are actively planning to end their career early and this could lead to a serious workforce crisis in general practice very soon. A growing and ageing population coupled with a surge in patients with multiple and chronic conditions was piling pressure on GPs but their share of the NHS budget has been slashed.

Since the creation of the NHS, GPs have been the bedrock of the NHS and provide excellent care for patients. But we can no longer guarantee a future for general practice as our patients know it, rely on it - and love it. It is very clear in the article that GPs are doing all they can and enjoy the trust and confidence of patients, but they are being seriously crippled by a toxic mix of increasing workloads and ever dwindling budgets, which is leaving patients waiting too long for an appointment and not receiving the time or attention they need and that GPs want to give them.

It is estimated that general practice will face a deficit of £2.7bn in 2021, which based on the typical costs of employing partner and salaried GPs would lead to a further shortfall of 7,500 GPs across England, on top of a present shortfall of over 8,000.

The profession has been brought to its knees both by a chronic slump in investment and the fact that there are now simply not enough family doctors to go around. General practice is at the heart of the NHS and if it is left to wither, as is the case now, it could sow the seeds of an unprecedented disintegration of the NHS at all levels.

If the present administration believes that it could starve the general practice into submission and bring in  private providers to take over, it will be mistaken too. By which time it will be too late for primary care to be rescued and care will be much the poorer (and more expensive) for it.

All major political parties must pledge before the election to increase investment in general practice to at least 11% of the NHS budget and announce measures to help recruitment and retention in the general practice.

* Dr Chand is BMA deputy chairman

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