Viewpoint: International study backs NHS as GP role under threat

With the NHS under siege from overwhelming pressures and short-term policy gimmicks from politicians from all sides, the latest report from the Commonwealth Fund is a welcome relief, writes BMA deputy chairman Dr Kailash Chand.

Dr Chand: 'There is a spirited fight back going on to make politicians realise we need to address the problems we are facing.'
Dr Chand: 'There is a spirited fight back going on to make politicians realise we need to address the problems we are facing.'

This international study rates the NHS as the best healthcare system in the world and the second cheapest. It places it well ahead of the US system, which performs poorly across a range of indicators.

One key factor for this success is the effective role general practice plays in the NHS as a gatekeeper of the health care in UK. But this is now undoubtedly under threat.

£2bn funding gap facing the health service

Ever increasing demand, especially from an ageing population is placing an incredible strain on GP practices up and down the country. GPs are working harder than ever before, getting through an estimated 340 million consultations a year, but most simply have no extra capacity to give not least as their budgets are being squeezed badly.

As today’s news reported, there is a £2bn funding gap facing the health service, but there are even more acute pressures on the ground in general practice.

GPs considering retirement

Resources are flatlining at best, while practice expenses continue to rise, now accounting for almost two thirds of all GP income.

This comes at a time when many buildings are in a state of decline, in many cases not big enough to deliver the services the government expects GPs now to deliver.

Unsurprisingly the morale of the profession is heading towards rock bottom, a majority of  GPs I meet are considering retiring early and the BMA’s own recent survey showed six out of ten were considering the same option.

To add to that we have a GP recruitment crisis. Take-up of family doctor training is at its lowest level since 2007. The proportion of family doctors serving every 100,000 people has also dropped, from 70 in 2009/10 to 66.5 now. Overall across the UK there were 451 vacancies for GP trainee positions, a staggering figure.

Despite this gloomy picture, the recent launch of the BMA’s Your GP Cares campaign and the mood at May’s LMCs conference shows there is a spirited fight back going on to make politicians realise we need to address the problems we are facing will gather momentum next week at the BMA ARM in Harrogate.

We need to support the central role of general practice underpinning the NHS, as well as the central gatekeeper role of general practice in managing demand and costs. Government needs to provide long-term sustained investment in the GP workforce, premises and resources.

It is in the interest of the government and patients that we work together to restore the ‘jewel in the crown’ status of the general practice.

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