GP crisis: Welsh government values general practice, but must act fast to save it

Workload, workforce and resources are the central challenges facing Welsh general practice, GPC Wales chairwoman Dr Charlotte Jones told LMCs last month. Reflecting on the Welsh LMCs conference, she says the government in Wales has shown that it values general practice - but must act swiftly to steer it through the current crisis.

The Welsh LMC Conference always produces interesting, thought-provoking discussions on a wide range of subjects. This year was no exception. The warm welcome given to all delegates encouraged an impressive breadth and depth of contributions. It is always good to see many of the experienced LMC members back for conference, but also heartening to welcome new faces and in particular, a fair sprinkling of GPs in training.

The chairmanship provided by Eamonn Jessup and Nimish Shah saw us cover a wide array of areas from the traditional 'motions to conference' as well as two themed debates – the first on 'QOF – should it be abolished?' and the second on 'independent contractor status vs salaried service'.

Maintain QOF

I have to say I was surprised to see that conference voted to retain QOF. Whilst alternatives were explored, there was a general feeling of 'better the devil you know', as opposed to starting something new without the confidence that any detail had been considered at length. There was a weary acceptance that whilst QOF is a burden in these challenging times, the GPC Wales negotiating principles for removing unnecessary bureaucracy, lengthening timeframes for most indicators and enabling the management of the individual patient rather than simply doing tick box medicine, was the correct one.

The salaried vs independent contractor status debate was fascinating and ultimately conference voted to support the GPC Wales stance. Our position focuses on enabling flexible working options throughout a GP's career, including through salaried posts to GP practices, ideally with a model contract. The risks of moving to a wholly salaried service won’t be rehearsed here, but were in line with our GPC Wales strategy document General Practice: a Prescription for a Healthy Future.

We were lucky enough to have Dr Richard Lewis deliver the keynote speech to conference. Many readers will know that Richard is a GP with a special interest in pre-hospital care who was the secretary for BMA Cymru Wales for many years. He has recently been appointed to the role of director of primary care within Welsh government, and this is a heartening appointment bringing his expertise across healthcare to Welsh government.

Valuing primary care

This is a clear indication of the value that Welsh government is placing on primary care. His speech focused on the challenges facing both the profession and the Welsh government and confirmed that primary care, in particular general practice and clusters, are at the forefront of Welsh government policies. The speech was very well received, and delegates gave Richard a standing ovation.

My own speech featured the three main challenges facing general practice: workforce, workload and resources. I outlined the work we have done, and further work that is needed to make Wales the place to work as a GP. While we all know there are significant pressures - which nobody is denying - there are always opportunities to be taken during difficult times.

The potential to change things and put in place urgent solutions to address the immediate pressures are with the government. Change is happening but conference confirmed the GPC Wales stance that more momentum and visible change on the ground is needed urgently.

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