Dr Kailash Chand: NHS five-year view is jam tomorrow

At first glance, this pledge from NHS England appears to be just what one would have wished for: '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.'

However, on closer scrutiny, it is 'jam tomorrow', not the desperately needed 'jam today'.

What we need is more GPs, more staff, including nurses, and a programme of investment in practice buildings to bring them up to scratch.

Health secretary Jeremy Hunt, instead of offering 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 dire because we could have a scenario where we do not 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 the combination of rising patient demand and declining resources. The government is asking GPs to provide more services, including many involving the transfer of hospital care to the community, without the resources required to deliver them.

Small practices, particularly in rural and deprived areas, could be forced to close because of the toxic mix of bigger workloads and smaller budgets.

Practices are being brought to their knees by this.

Funding for general practice in England has slumped to just 8.5% of the total NHS budget. It is imploding 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 immediately to at least 10% of the NHS budget. Without this, the reality is that patient care - and the very future of the NHS - is at risk.

We need Mr Hunt and NHS chief Simon Stevens to listen to GPs and find a workable solution to these problems today.

  • BMA deputy chairman Dr Kailash Chand is writing in a personal capacity.

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