Viewpoint: Dr Kailash Chand: NHS Five Year Forward View is 'jam tomorrow, not jam today'

Today is the Hindu festival of Diwali, equivalent of Christmas for Christians writes BMA deputy chairman Dr Kailash Chand.

Dr Chand: 'Small practices could be forced to close because of the toxic mix of increasing workloads and smaller budgets.' Pic: Michele Jones
Dr Chand: 'Small practices could be forced to close because of the toxic mix of increasing workloads and smaller budgets.' Pic: Michele Jones

The following pledge from NHS England on first look appears to be the best gift one could have wished for at the beginning of the festive season: ‘The foundation of NHS care will remain list-based primary care. Given the pressures they are under, we need a ‘new deal’ for GPs. Over the next five years the NHS will invest more in primary care, while stabilising core funding for general practice nationally over the next two years. GP-led CCGs will have the option of more control over the wider NHS budget, enabling a shift in investment from acute to primary and community services. The number of GPs in training needs to be increased as fast as possible, with new options to encourage retention.’

An empty illusion of 'jam tomorrow, not jam today'

On careful scrutiny, it is an empty illusion of 'jam tomorrow, not jam today' which is desperately needed. What we need is more GPs, more practice staff, including nurses, and a programme of investment in GP practice buildings to bring them up to scratch. The NHS bashing, which is now an almost daily feature from politicians needs stopping. Mr Hunt, instead of empty rhetoric, must invest in training, education and funding in primary care. Another problem is starting to rear its head. More than half of all GPs say their morale is either low or very low and two-thirds are considering early retirement. This is a dire situation because we could have a scenario where we don't have enough GPs to replace the ones leaving the NHS, which would have a terrible impact on patient care.

The root cause of the crisis is this unprecedented combination of rising patient demand and declining resources. The government is also 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.

Small practices, particularly in rural and deprived areas, could be forced to close because of the toxic mix of increasing workloads and smaller budgets. Practices are being brought to their knees by this unprecedented fall in money for primary care and rising demand for GP services. The funding for general practice in England has slumped to just 8.5% of the total NHS budget. It is imploding faster than people realise and patients are already bearing the brunt of the problem.

To avert a recruitment and retention crisis, funding for general practice needs to be increased to at least 10% of the NHS budget immediately. Without this, the reality is that patient care – and the very future of the NHS – is at risk.

We need Mr Hunt and Simon Stevens to listen to what GPs are telling them and find a workable solution to these problems today and not wait for tomorrow, if they are serious in avoiding the inevitable crisis/meltdown in general practice.

Diwali is about light, not darkness. Love, not hate, hope not despair.

Happy Diwali to all GPonline readers.

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