Dr Kailash Chand - Study backs NHS as GPs under threat

With the NHS being besieged by overwhelming pressures and short-term policy gimmicks from politicians on all sides, the latest report from the Commonwealth Fund is a welcome relief.

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, which performs poorly across a range of indicators.

One key factor for this success is the effective part played by general practice as the gatekeeper of healthcare. But this is now under threat.

Ever-increasing demand, especially from an ageing population, is placing incredible strain on practices up and down the country.

GPs are working harder than ever, carrying out an estimated 340m consultations a year, but most simply have no extra capacity, not least because their budgets are being squeezed.

There is a £2bn funding gap facing the health service, but there are even more acute pressures in general practice. Resources are flatlining at best, while expenses continue to rise, now accounting for almost two-thirds of all GP income.

This comes at a time when many GP premises are in a state of decline, and are often simply not big enough to deliver the services the government now expects from GPs.

The profession's morale is heading towards rock bottom. To add to this, 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 dropped, from 70 in 2009/10 to 66.5 now.

Despite this gloomy picture, the 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 face.

We need to support the central role of general practice underpinning the NHS, as well as its gatekeeper role in managing demand and costs. The government needs to provide long-term sustained investment in the GP workforce, premises and resources. It is in everyone's interest to work together to restore the 'jewel in the crown' status of general practice.

  • Dr Chand is BMA deputy chairman.

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