Spending review 'falls short' for general practice, warns top London GP

The government's spending review 'falls short' of what general practice needed to address the challenges faced by the profession, a GP leader has warned.

Dr Michelle Drage

Chief executive of Londonwide LMC and GPC member Dr Michelle Drage said chancellor George Osborne’s announcement, setting out the government’s spending plans for the next four years, contained ‘nothing new’ for GPs.

The DH announced its settlement with the Treasury on Tuesday, including an additional £3.8bn for the NHS in 2016/17, frontloading some of the £8bn a year increase promised by 2020.

The Treasury said it was committing £750m to funding evening and weekend services and 5,000 new GPs, but NHS England was unable to clarify if that was a new allocation of funding or money previously announced.

Mr Osborne said the NHS was the government’s first priority. ‘we have been increasing spending on the NHS in England. In this spending review, we do so again’, he said.

NHS efficiency savings

‘We will work with our health professionals to deliver the very best value for that money. That means £22bn of efficiency savings across the service.’

Mr Osborne announced: 

  • NHS England will receive £10bn more a year in real terms by 2020 than in 2014/15, some of which will fund seven-day GP services for all patients by 2020.
  • Mental health services will receive an additional £600m a year.
  • Nurse training will lose its direct funding, replaced by loans. The government said this will allow it to expand recruitment by 10,000.
  • Local authorities will be given the power to levy a 2% social care precept on council tax.
  • The Better Care Fund for integrating health and social care funding will be increased by £1.5bn by 2019/20.
  • Mr Osborne said he was making ‘the largest investment in the health service since its creation’.

But Dr Drage said the announcement was ‘nothing new’ for GPs.

Seven-day NHS

‘Next day appointments, named GPs and seven-day access are great ideas, but there is neither the time, money or morale for many GPs within the profession to deliver them at present.’

She called for ‘up front’ funding so GPs could manage existing workload before they can improve access.

‘The biggest challenge GPs and their teams in London face is declining morale resulting from increasing workload not matched by increases in workforce. We have seen massively increased demand at the doors of all our general practices as community, social and mental health services which used to support GPs have been dramatically reduced, and as we try to handle all the multiple conditions that accompany our diverse, often deprived, highly mobile and ageing society in the face of a diminishing workforce.

‘Each year in London the equivalent of fewer than 5,000 GPs and falling handle over 50m consultations and we need over 1.5m more GP hours to deal with current demand. With practice nurse numbers falling as well, the government needs to properly fund existing services, cut red tape and manage patient expectation before pushing general practice to deliver even more with less.’

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