This week NHS Digital released spending figures which provide the definitive facts about how much investment has gone into general practice in England last year. This is a subject that is often obscured by the fog of political rhetoric, and as many GPs have found, the promises made by politicians of all parties often bear little resemblance to what is actually happening on the ground.
In many ways these figures, together with the analysis the BMA produced immediately after their release, demonstrate that GPs are right to take a sceptical view.
There has undoubtedly been more money going into GP services in the last few years, with the majority of this additional funding coming from gains made by the BMA in recent contract talks. With £220m as part of the 2016/17 contract deal, together with a further £101m delivered to GP services as a result of population growth and other changes, new, recurrent and much needed resources have been secured. But it would be wrong to believe that this has solved all the pressures on the profession.
The most disappointing finding from the BMA analysis is that the health service spend on GP services as a proportion of the NHS budget is still well below the level it was at a decade ago. Despite the significant work that has flowed from secondary to primary care only 7.9% of overall NHS investment is currently going to general practice compared to 9.6% in 2005/6.
A simple calculation shows that this means GP practices are receiving £2bn less than they would have been had spending been maintained at 2005/6 levels. If this was not disappointing enough, the government is also not meeting the target of 11% of the overall NHS budget being allocated to general practice that the BMA and RCGP have consistently called for. It is currently £3.7 billion short of meeting this target.
And finally, there has been a noticeable slowing in the increase in spending on patient care in general practice, falling from 5% in 2015/16 to 3% last year. All of this means the average practice receives just £151 per patient for a year of unlimited care. No wonder so many practices are struggling with workload pressures and haven’t got sufficient resources to expand their practice teams.
Many GPs are of course already dealing with the practical implications of these figures as best as they can. The staff shortages, the declining state of their buildings, the rising expenses outstripping their stagnating budgets and the steadily increasing number of patients who need specialist services they can rarely deliver are all issues that undermine morale and lead to so many GPs considering their own future in the service.
The government must take these funding figures seriously, especially as they come just a few weeks after the BMA released a survey showing that more than half of GP practices were in such a desperate state they were considering closing their practice lists. Time is fast running out to stop GP services collapsing further into crisis this winter: they have had enough warnings, it is time for politicians to act.
- Dr Richard Vautrey is chair of the BMA's GP committee (GPC) and a GP in Leeds