Labour conference: GPs would work 'very differently' under Labour

GPs would have to 'work very differently' under a future Labour government, according to shadow health secretary Andy Burnham.

Andy Burnham: GPs' focus must change
Andy Burnham: GPs' focus must change

Mr Burnham told GP at his party’s annual conference in Brighton that under his plans for integrated health and social care GPs would focus more on preventive and social care.

Speaking ahead of his main address to his party’s conference on Wednesday, Mr Burnham said decisions about the organisation of general practice should be taken locally.

‘I’m very open minded about the different models that might emerge. It might be a more GP-led model. It might be a more community and mental health trust model. It might be a foundation trust-led model.’

‘But I do envisage GPs working very differently’, he added.

‘Prevention - not waiting for people to come to the surgery, managing people at home, ensuring they are monitoring their blood sugar, all of those kinds of things.’

Mr Burnham, who has spent time recently shadowing GPs, said general practice budgets should be expanded to allow social prescribing.

He said: ‘I want GPs to work in that social context I described. I spent some time shadowing GPs over the last few months and sat through their surgeries. And the main conclusion I have is they are very similar to my surgeries as an MP. A lot of people who come through the door have no physical health problems; it’s often clear to me their problem is a social problem - it’s bereavement related, it’s work-related, it’s housing-related. All kinds of things.

‘I’ve seen GPs give prescriptions for antidepressants. And I’m not blaming them for doing it. But I say, wouldn't it have been better if you could send them for bereavement counseling today. Not in four weeks; right now. Or, I’ll send you for addiction treatment, today. Because someone’s ready for change if they’ve gone to the GP. Or wouldn’t it be better if they could say, ‘I’ll buy you that walk-in shower this week, just get it done because it’s getting you down, isn’t it, not having a bath every day.’

Mr Burnham’s comments came just before Labour leader Ed Miliband’s speech, in which he made the NHS a key plank of the party’s 2015 election campaign.

Mr Miliband said prime minister David Cameron was responsible for the A&E crisis, the Conservatives were wrecking the NHS, and Labour would rescue it.

Mr Burnham gave his backing to a trade union-led ‘Save our NHS’ protest against privatisation at the Conservative party conference in Manchester next weekend.

Leading Labour health campaigner and Lewisham GP, Dr Brian Fisher told GP that independent contractor status was ‘no longer effective’ for proactive integrated care.

Dr Fisher, vice president of Labour’s Socialist Health Association, said: ‘My own view is that the infrastructure of general practice probably has to change in some way, because if you look at the requirements for population health, for proactive care, long-term conditions, you think about operating in a completely different, much more interactive way with our communities, then I think we really have to consider a different way of incentivising general practice, to ensure the skills and assets of general practice are used in the most effective way.’

Dr Fisher said he did not favour a salaried service and there were no easy solutions.

He was ‘generally enthusiastic’ about Mr Burnham's plans for whole-person integration of health and social care, and health and wellbeing board commissioning, but warned that detail on general practice was ‘sparse’.

However, Dr Fisher said he was opposed to any possibility of vertical integration with general practice taken over by hospital trusts, which Mr Burnham’s team may favour.

On Sunday, shadow health minister Lord Philip Hunt told party delegates that the GP contract was not fit for the 24-hour service the NHS needs.

On Monday RCGP chairwoman Professor Clare Gerada told the conference: ‘I think general practice needs to change, because I think we need to look at some of the structural issues around general practice including how we are contracted as independent contractors so that … we can start to release some funds and pool them, so the tax pound is used in one place for the patient rather than spread across.’

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