In the short time I have been shadow health secretary I have been inundated with letters, emails and phone calls from hundreds of GPs from across the country. Their postcodes might be different, but their concerns are the same. General practice is under-staffed, under-funded and under-prioritised. This is having a knock-on effect right across the NHS, with A&E departments getting busier and busier because of over-stretched primary care services.
General practice is the first point of call for the vast majority of patients. The profession deals with nine in 10 of the NHS's patient contacts and the caseload is extremely varied: from family planning through to planning for the end of life, spotting suspected cases of cancer to identifying symptoms of poor mental health.
There is no doubt that growing patient demand requires an adequate workforce. At the election, Labour promised to fund and recruit an extra 8,000 GPs during the course of the Parliament. We were right to make that commitment. Put simply, there is a workforce crisis spreading across general practice.
GP recruitment crisis
Take the senior partner in a practice on the south-east coast who I spoke to just before Christmas. His practice had recently advertised for a new GP and had just one applicant. One applicant, when 20 years ago it would have been 30 or more. This recruitment crisis is placing a massive squeeze on current capacity and it is patients that are suffering.
Jeremy Hunt's promise of 5,000 more GPs has already unravelled. Officials admit that a quarter of that target includes people already working in the profession. In the coming months, I will be holding the health secretary's feet to the fire over this, but I will also be looking at how we can address the staff shortages today and create a sustainable workforce for the future.
Staffing issues are being compounded by a funding shortfall. General practice's share of NHS funding has historically been low. However, the situation has worsened over the past five years. The amount of funding has fallen from 11% of the total NHS budget a decade ago, to around 8.4% at the moment. Money is being sucked into the acute sector at the expense of community care. This is a false economy and it is not sustainable.
GP practice closures
Since starting in my new role I have repeatedly heard about practices that have stopped taking on new patients because they can no longer cope with rising demand. A GP I spoke to in Northampton told me how his colleagues were faced with doing this because of concerns over patient safety. Small and rural practices are also at risk of closure because of contract changes that were made during the last parliament, while a review of current contracts is also raising significant concerns.
We cannot ignore these warning signs any longer. Ministers need a proper plan for investing and reforming general practice.
Debates about the future of the NHS will prove futile if they are just focused on the fate of a local hospital or the pressure on A&E. The difficulties our system face expand way beyond the hospital car park and the answers do too.
GPs at heart of future NHS
During the next five years we must respond to the challenge of how we can build a health and care system that is fit for a 21st century population. We need to look at the entire health and care system and how it can meet modern demands - from caring for people in the community through to improving rates of diagnosis for the country's big health killers. General practice must be at the heart of this debate.
I'm not going to profess to have all the answers - nor am I going to say the solutions are easy. My job is to listen to you - the people on the frontline - and to then come up with the ideas for what a Labour government in 2020 could do to improve primary care so it works for patients and GPs for generations to come. It's a conversation I look forward to starting – and I hope you'll be part of it.
Thanks to Dr Brian Fisher, GP and vice-president of the Socialist Health Association for arranging this contribution from Heidi Alexander.