General practice 'at serious risk of collapse', says GPC chair

General practice is 'at serious risk of collapse' - threatening the foundations on which the NHS is built, the BMA's top GP has told the union's annual conference.

GPC chair Dr Richard Vautrey
GPC chair Dr Richard Vautrey

GPC chair Dr Richard Vautrey warned on Tuesday that record numbers of practice closures, GPs reporting extreme workload pressure, a decline in the GP workforce and many GPs seeking help for stress and burnout revealed 'serious structural faults' facing the profession.

Developments such as the government's pledge to increase NHS funding, the prospect of state-backed indemnity for GPs and the GP partnership review showed 'we are winning the argument', he told the conference in Brighton.

But Dr Vautrey cited GPonline's exclusive report that more than 1,000 GPs had referred themselves to the GP Health Service for support with stress and mental health problems within the service's first year as evidence of the extreme pressure on general practice.

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'For far too long our service has been undervalued and taken for granted,' the GPC chair told the conference. 'GPs’ work ethic and dedication to their patients has been exploited through a decade of underfunding and soaring workload pressure, with the assumption that the GP practice will always be there to pick up the workload that others say they cannot or will not do.'

He said that throughout its 70-year history, general practice had been 'the foundation on which the NHS has been built'.

'But when nearly 40% of GPs intend to quit direct patient care in the next five years, and over 90% of GPs are reporting considerable or high workload pressures, we know that the foundation of general practice has serious structural faults,' he said.

'When instead of gaining an additional 5,000 GPs, we’ve lost over a 1,000, we know that the foundation of general practice is cracking.

'When over a 1,000 GPs have referred themselves to the new GP Health Service in England because of stress and mental health problems, or when hundreds of practices have closed and over 1m patients have been forced to look for a new GP service, we know that the foundation of general practice is breaking down.'

GP contract

Dr Vautrey warned that general practice was 'seriously at risk of collapsing', but could be saved with the right intervention. He pointed to the revamped GP contract for Scotland, QOF suspension in Wales and a new funding package in Northern Ireland as reasons for hope - and said that in England, the BMA had set out how new funding pledged as part of the government's long-term NHS spending plan must be invested.

He called for workforce plans to be stepped up, premises investment, a 'step change' in IT support and improvements to the much-criticised primary care support services run by outsourcing company Capita. Dr Vautrey welcomed plans for state-backed indemnity and the review to reinvigorate GP partnerships led by Wessex LMCs chief executive Dr Nigel Watson.

He said: 'Despite the challenges and the pressures, the government’s recent announcements show that we are winning the argument but there is much that still needs to be done. We will not give up on our vital task to save general practice, to rebuild the solid foundation on which the NHS has been built for 70 years and work with the whole BMA to ensure our patients get the best possible healthcare for generations to come.'

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