LMC Conference 2014: General practice in a parlous state, warns GPC chairman

General practice is in a 'parlous state, facing unprecendented challenges', the GPC chairman told the 2014 LMCs conference in York on Thursday.

GPC chairman Dr Chaand Nagpaul (Photo: Pete Hill)
GPC chairman Dr Chaand Nagpaul (Photo: Pete Hill)

Dr Chaand Nagpaul, speaking for the first time at an LMCs conference as GPC chairman, warned the government that if it wanted a sustainable NHS, it must consider whether it could continue to fail to invest in general practice.

He won a 50-second standing ovation for a speech in which he warned: ‘I will not preside over the destruction of a discipline that like for you is my life, my vocation, and defines my values.’

Young doctors, Dr Nagpaul warned, were shunning careers in general practice because of ‘the intolerable pressures that GPs are subject to, together with relentless attacks that devalue what we do, and which has butchered the joy and ability of GPs to properly care our patients’.

GPs face quadruple threat

The profession faces a ‘quadruple whammy’ of a crisis in workload, workforce, premises and morale, he warned.

The GPC chairman called for a 2.5% increase in the share of NHS funding going to general practice.

Dr Nagpaul demanded support for practices hit hard by the removal of MPIG funding, hit out over the withdrawal of occupational health support for doctors, and condemned the government’s £50m Challenge Fund as a ‘kick in the teeth’ for GPs.

‘While £500 million was given to ease the pressures in accident and emergency, it’s a kick in the teeth for general practice to receive £50 million not to ease any crisis or pressure, but actually to provide even more over seven days,’ the GPC chairman said.

GPs taken advantage of

He spoke out strongly against NHS England for ‘taking advantage’ of the capitation-based GP contract to pile ever more work onto the profession while other parts of the NHS were paid in line with levels of work.

‘It’s indefensible to have a funding system that pays for every contact and procedure in other parts of the NHS, while taking advantage of the capitated GP contract by piling open-ended work onto practices to simply absorb without any new resources or capacity,’ Dr Nagpaul told the conference. ‘This is unfair to patients who are subject to a pass the parcel experience that ends up in the GP surgery when the music stops.’

Dr Nagpaul hit out over plans to remove £235m in PMS funding from GP practices, warning the funds must remain within general practice.

GPs need support

He called for more CCG support for practices and member GPs.

He urged the government to reinstate the GP retainer scheme, and called for an end to barriers to GPs returning to work.

‘It's only by making the job manageable, rewarding and in suitable premises that you stand a chance of improving recruitment,’ Dr Nagpaul warned.

The GPC chairman added that GP practices desperately need more staff to deal with ‘escalating patient volumes’, and expanded primary care teams built around general practice, with better links to community nursing staff.

Read more: Dr Chaand Nagpaul's speech in full

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