Jeremy Hunt admits failure to prioritise GP workforce in four years as health secretary

Health secretary Jeremy Hunt has admitted failing to prioritise building the GP workforce during his time as health secretary in a speech pledging to remove barriers to moving more NHS work into primary care.

The health secretary told the Best Practice conference in Birmingham on Thursday that he would strip out 'condition by condition' barriers and inflexibilities that have held back the transfer of work out of hospitals and into primary care.

Mr Hunt said short-term priorities often led health secretaries to ignore longer-term needs such as workforce planning, and admitted that failing to invest in GP training had now 'caught up' with him.

But the health secretary highlighted plans set out at the Tory conference last month to boost medical graduate training - saying it would be 'irresponsible' for the UK not to be self sufficient in doctors. He added that GP trainee recruitment was going well this year.

He told the conference that one thing he had not been silent on was the ‘critical importance of primary care’, and how more care should be moved out of hospitals into the community.

GP workforce

Although general practice has ‘not received the attention it needed’, this will be rectified when general practice’s share of NHS funding is restored to over 10% of the total by the end of this parliament, he said.

He said the government was looking at ways to enable general practice to take on more care traditionally undertaken by hospitals, including introducing ways of funding GPs for the extra work.

‘This means looking at payment systems – because, obviously if we’re asking GPs and practices to do more work, then they need to be paid for doing that extra work,’ he said.

‘But it also means removing some of the inflexibilities. We will be hearing more of what I'm calling the GP One-Stop Programme – looking at areas like diabetes, end-stage renal and many others. We’re going to go through situation by situation, condition by condition, and asking what barriers we can remove centrally to allow more of this work to happen in general practice.’

He added that he recognised workforce shortages as the ‘biggest worry’ among GPs, admitting that this was something he had not prioritised in his time as health secretary.

Mr Hunt said: ‘I think I have to hold my hand up as secretary of state – but actually I think that all governments over the decades have not got right their workforce planning.

NHS funding

‘Typically, the problem is that when a health secretary negotiates a spending settlement with the chancellor, he or she knows that money spent on training extra medical students won't benefit the NHS for seven years, whereas money can be spent right away on improving cancer care or other things where there are urgent priorities.

‘And that of course means there's always a temptation to ignore the longer term – but the problem is that the longer term catches up with you.'

Mr Hunt said he had been 'very proud' to set out at the recent Conservative party conference his plans to increase medical student places by up to 25% from 2018.

‘We want to train up to 1,500 more medical students to be doctors every year. In the decade ahead – with the pressures of an ageing population we face – we will need to put more resources into the health and social care system.

‘But if we don’t have the doctors, the nurses, the midwives and other clinicians there, in the end, the impact of that spending won't be what we desire.

‘I want to be absolutely clear, that when I use the word "self-sufficient", this is in reference to the number of doctors we train. I do believe, as the fifth largest economy in the world, we should be training the number of doctors and nurses we need.

EU doctors

‘But it is in no way a reflection on the fantastic work that many overseas doctors do in the NHS. I've made it very clear that we want them to continue working in the NHS post-Brexit – the NHS would fall over without them.

‘And we will always want international exchanges – it is incredibly beneficial to the NHS and indeed to other countries.

‘But, given that there is a worldwide shortage according to the WHO of 2m doctors, given that we are not the only country with an ageing population, and given that you have India and China rapidly expanding the reach of their own healthcare systems – I think it would be plain irresponsible for us not to be training the number of doctors we need.’

Mr Hunt told the conference that Health Education England had made progress on increasing recruitment to GP training posts to record levels, and that steps forward had been made in attracting trainees to underdoctored areas.

He said the fill rate had gone from 62% to 78% in the east of England, and from 69% to 95% in north-east England.

Responding to the GP trainee comments, GPC workforce, training and education lead Dr Krishna Kasaraneni said: 'The BMA has been working with HEE and other bodies to try and improve the recruitment of GPs at what is a critical stage for general practice.

'While acknowledging that GP recruitment has improved, the government needs to realise that GP services are facing endemic shortages across the workforce with too many GPs leaving the profession and too few medical graduates joining. This is down to the incredible workload and funding pressures on GP practices that make the profession less attractive to work in than it once was.

'These new figures still leave general practice in England hundreds of GPs short of the target set by the health secretary. We need the government to urgently implement its recent promises in the GP Forward View so that we can recruit and retain enough GPs to deliver effective care to patients.'

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