Dr Charlotte Jones memorably told last year's Welsh LMCs conference that general practice was 'not just on its knees but more flat on its back with legs in the air'. But after 18 months as GPC Wales chairwoman, she is optimistic about efforts to resurrect the profession.
Speaking to GP ahead of the 2015 Welsh LMCs conference on Saturday, she says: 'There has been a growing acknowledgement of the critical problem with the workforce in Wales across general practice, and there has been a push to actually do something about that.'
Last year, Dr Jones spoke about the pressing need to train and retain more GPs.
'One area that is sitting with the minister is a reconfiguration of the GP returner scheme,' she says. 'We need to increase exposure to foundation training places, and we need to have a range of incentives to attract people into Wales because it's a fabulous place to work.'
Her team has been trading ideas with the Welsh government about how to do just this. 'It's a case of how quickly that will come to fruition.'
GPC Wales has focused its efforts on GP 'clusters' - a mechanism for linking general practice with community and social care services - as part of a three-year development plan.
With the first year almost at an end, has it delivered the collaborative approach to patient care that Dr Jones was so optimistic about?
Some clusters have thrived, while others have 'not had such a good experience', she admits, but Dr Jones is certain that given time, GPs and community services will work closely together to improve patient care.
'Even the clusters that have had some issues in terms of being able to take forward ideas and actions have felt benefit in the professional dialogue between practices, which has been lacking because of pressures over the years, and we have started the process of collaborative working.
Building on cluster work
'We hope to build on the work of the clusters now that they've had a year to start developing.'
Dr Jones gives the example of the 'virtual ward' system in Powys, where GPs, occupational therapists and social workers care for elderly, frail patients without them having to travel. Other clusters have developed screening programmes for breast cancer and arrhythmia.
'We need to look at why these examples have succeeded, and how they could share this with other clusters that might not be quite at that stage, to find out why they're being held back,' she says.
'We'll be doing a survey on that to get a sense of what kind of support clusters need to be able to reach their potential.'
The Welsh government announced a £10m injection into primary care, with £6m for clusters and £4m to develop infrastructure to support them. 'We are grateful for the Welsh government listening to our lobbying for increased investment, and we're pleased we have seen significant investment in primary care.
'It shows the government is putting some new resource into primary and community care,' she says.
As the BMA launches its 'No More Games' campaign to stop politicians playing 'political games' with the NHS, Dr Jones warns the NHS has become a bargaining tool in the run-up to the general election.
'All parties could raise inappropriate expectations for the public which are not deliverable, which is not fair,' she says. 'It's a concern to the profession when you think you'll have to deliver all this when you know you're already struggling. The workforce is already under strain.
'We need to stop the NHS being used as a political football between parties and nations. We need a cross-party consensus on what the NHS can afford and what it should deliver to patients, because demand in primary care is rising all the time.'
With GP contracts now under a three-year deal in Scotland, does Dr Jones see the Welsh system moving in a similar direction?
'There's a sense of change fatigue in general practice so if we had a longer period of stability that would enable practices to plan their finances.'
GPC Wales has asked the Welsh government to consider a Scottish-style three-year deal, but talks are ongoing. Meanwhile, with so many practices in Wales struggling with finances, GPC Wales is working on a support system. 'What we've been looking at is the Sustainability Programme whereby practices that are restrained because of financial changes can have support to improve service provision to patients.'
While details of the programme are yet to be confirmed, Dr Jones is clear it will not replace MPIG payments, but help any practice having difficulties.
'It's in nobody's interest for patients to have access to less availability to GP-led services,' she said.
She hopes the programme will help general practice in Wales to get back on its feet. 'We acknowledge that general practice is under enormous pressure, but we are glad that the Welsh government recognises that and is prepared to put investment into that,' she says. 'I'm an optimist. I'm passionate about how brilliant Welsh general practice is, and having it at the forefront of primary care is of immediate benefit to the Welsh NHS and patients.'