Viewpoint: Lack of out-of-hours funds not GP contract to blame for A&E pressure

This month has seen a series of unhelpful and inaccurate comments from ministers about the GP contract, the state of out-of-hours care and the impact of both on emergency admissions, writes Dr Kailash Chand, deputy chairman of the BMA.

Dr Chand: 'The botched introduction of NHS 111 has not helped matters.'
Dr Chand: 'The botched introduction of NHS 111 has not helped matters.'

There is little doubt that there are challenges facing the NHS, but the factors behind them are complex, interrelated and unlikely to be tackled successfully by blaming NHS staff.

Firstly, let’s start on the positives that the government has neglected to mention. Delivering high quality patient care is the most important priority of GPs irrespective of the politics of the day or form of the contract (GMS/PMS etc).

GPs prevent thousands of patients each year from having a stroke, heart attack, and other serious health problems. We keep patients out of hospital and save the NHS millions. The evidence is clear that countries where the health systems are more orientated to primary care achieve better levels of health, higher life expectancy, greater satisfaction with healthcare among their populations, lower costs and medication use.

Our system of general practice offers an amazingly cost-effective service with a quality of care that is second to none. Initiatives to undermine the traditional general practice would be a disaster. I believe health secretary Jeremy Hunt's recent speech is ill advised to say the least, especially as he has sought to blame GPs for the inadequacies that often stem from wider factors. 

He has to accept that the ever increasing squeeze of funding to GP practices and the wider NHS, coupled  with the impact of coping with an aging population and spiralling patient demand has left the NHS facing unprecedented pressures.

The botched introduction of NHS 111 has not helped matters not least as it has in some areas created extra work for already over stretched A&E departments and out-of-hours services. Given this climate, it is simply not accurate to lay all the blame for rising emergency admissions or problems with out-of-hours services at the door of the GP contract.

On out-of-hours care in particular this government has had the opportunity to provide extra funding to meet rising patient demand, but instead has adopted the approach of maintaining historic underfunding of this key service. While more and more people call the service, funding has remained static for the last three years.

In some senses, the health secretary does seem to acknowledge that workload is rapidly becoming more and more unsustainable. But the way to cope with this is not by taking shots at harder working NHS staff who having to work harder with fewer resources. It is high time the government seriously engages with the BMA’s leadership and other healthcare professionals and patients, to resolve numerous issues facing primary care.

* Dr Kailash Chand is the deputy chairman of the BMA.

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