Hunt 'wrong to scapegoat GPs' for pressure on A&E

GP leaders have hit out at health secretary Jeremy Hunt for blaming the 2004 GMS contract and practices for rising pressure on emergency care services.

A&E: BMA anger over Jeremy Hunt remarks
A&E: BMA anger over Jeremy Hunt remarks

Mr Hunt blamed ‘the disastrous GP contract’ negotiated by Tony Blair’s Labour government for ‘four million people additionally using A&E every year’ in a House of Commons speech last week.

In a speech at the Age UK conference on 25 April, Mr Hunt reiterated the remarks and called for a rethink on the role of primary care in preventing emergency admissions.

NHS England medical director Professor Sir Bruce Keogh is set to announce the findings of a review of emergency care next month, and will look at how people with long-term conditions can be cared for better outside of hospital.

The BMA responded angrily to the ‘simplistic’ analysis of pressure on A&E and wrote to the health secretary demanding urgent talks. The RCGP also hit out at the health secretary's comments, warning it was 'not true that the rise in demand on A&E services is due to a reduction in out-of-hours provision by GPs'.

BMA chairman Dr Mark Porter said: ‘There is no doubt that the NHS is under intense pressure. Spending on healthcare is squeezed, patient demand is rising and staffing levels are often inadequate.’

But he warned: ‘The government’s analysis of where responsibility lies for the huge and increasing pressure on emergency care is completely simplistic. Singling out individual parts of the health service and engaging in a blame game is unhelpful and misses the point.’

He said GPs were taking on increasing numbers of consultations and were likely to take on more and more complex work as the population ages and expands.

GPC chairman Dr Laurence Buckman added: ‘The BMA has made it clear for many years that the provision of out-of-hours care in England needs to be improved, particularly in how it is resourced and co-ordinated, but it is wrong to blame the GP contract for problems with the system.

‘Out-of-hours care has historically been badly underfunded even before the introduction of the GP contract in 2004. Despite rising patient demand, funding has remained static in the last few years. The bungled introduction of NHS 111, which was intended to alleviate pressure on the system, has just made matters worse.’

RCGP chairwoman Professor Clare Gerada said: 'Once again, GPs are being used as a scapegoat and it is not acceptable. It is not true that the rise in demand on A&E services is due to a reduction in out-of-hours provision by GPs - and there is no evidence to prove that the increase is due to the GP contractual changes in 2004.'

The BMA letter to the health secretary reads:  

Dear Sir,

The BMA is extremely concerned about the overly simplistic, inaccurate analysis of the huge pressures on accident and emergency departments being promoted by the Government over the past few days. A clear message is emerging, highlighted in advance media coverage of the speech you are due to make at today’s Age UK conference, that you lay responsibility for these pressures with GPs.

In reality, the causes of the very real increased pressures are complex and not fully understood. Out-of-hours primary care will form part of the picture - we have been lobbying for many years for the ability and resource to make improvements and GPs remain very much key providers of urgent care during the weekends and evenings. But the current pressures will also be due to rising demand on the NHS, unmatched by increasing resources, insufficient staffing in A&E departments and bottlenecks elsewhere in the hospital system, as well as the bungled introduction of the NHS 111 urgent care service in many areas.

We welcome Sir Bruce Keogh’s review of urgent and emergency care and hope it will consider resourcing and co-ordination across the whole health service. We all want to see the provision of timely, effective and appropriate high quality medical care. Where this is failing we must work together to identify the causes and solutions rather than point the finger unfairly at health care professionals, the vast majority of whom who are providing a high quality service to their patients in the face of hugely increased demand and real-terms reductions in resources.

We would very much like to meet with you urgently to discuss how the medical profession can work with the government and others to find a constructive way forward.

*Money Talks blog: Hunt misses point when blaming GPs for A&E pressures

* Viewpoint: Lack of out-of-hours funds not GP contract to blame for A&E pressure

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