Javid says current primary care model is not working and promises 'plan for change'

Sajid Javid has told NHS leaders that the current model of primary care is 'not working' and promised a 'plan for change' - just months after backing a report calling for a predominantly salaried GP service.

Health and social care secretary Sajid Javid
Health and social care secretary Sajid Javid (Photo: Carl Court/Getty Images)

Speaking at the NHS ConfedExpo 2022 confererence in Liverpool on 15 June, Mr Javid acknowledged pressures facing the health service and highlighted health disparities between different parts of the country.

He said primary care was a 'crucial part of the puzzle' in NHS reform, adding that he was 'grateful to all primary care staff who make a difference to millions of people every single day'.

However, the health and social care secretary said: 'I don't think our current model of primary care is working. That won't be a surprise to you. I know you know, I think patients know and I think everyone working in primary care knows - we need a plan for change.'

Primary care reforms

Mr Javid said the DHSC was 'starting with pharmacy but I will be setting out my plans shortly' - adding that he was grateful to Dr Claire Fuller for proposals on improving access to primary care.

The comments at the NHSExpo event come just months after the health and social care secretary wrote the foreword to a report that called for the GMS contract to be phased out within a decade, with general practice becoming a predominantly salaried service operating within large-scale providers.

Senior GPs have warned that his comments have already exacerbated reluctance among GPs to take on partnership roles - with interests in partnership 'collapsing like a Jenga stack'.

The March 2022 report by the conservative Policy Exchange think tank - backed by Mr Javid as a 'pragmatic contribution to the debate on the future NHS' - said the partnership model was in 'terminal decline' - and called for a wholesale shift to providing primary care 'at-scale' from as soon as 2024.

GP partnerships

It called for GPs to be incentivised to partner with local hospitals in a 'vertical integration' structure, or to 'formally join forces with other practices to provide community and primary care'.

The report said that to 'align incentives across primary and secondary care, GPs should become predominantly salaried and contracted by scaled providers' such as NHS trusts, 'provider collaboratives' or 'large-scale primary care operators'.

Mr Javid - who has been in post for just under a year - had previously been reported to have told the prime minister that general practice should be nationalised, with GPs directly employed by hospitals. Mr Javid was also reported to have said there were 'considerable drawbacks' to the current model of general practice.

The BMA's GP committee last month voted in favour of a motion emphasising its support for the contractor model of general practice, warning that primary care networks were an 'existential threat' to partnerships - and rejecting any proposal to move to an all-salaried service.

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