Viewpoint: Dr Kailash Chand: Manifestos give no idea about general practice plans

Elections are food and soul of a democratic society but they have been reduced to the trivial, misleading and disappointing as far as the NHS is concerned, writes BMA deputy chairman Dr Kailash Chand, who is writing in a personal capacity.

Dr Chand: 'The health service for politicians has become a political football.' Pic: Michele Jones
Dr Chand: 'The health service for politicians has become a political football.' Pic: Michele Jones

With less than two weeks to go before the election I have no idea from their manifestos what the main political parties are going to do about the NHS in general and general practice in particular. The health service for politicians has become a political football, a mart and a bidding war.

All political parties are attempting to outbid each other on the number of doctors/GPs they could magically produce in the next parliament. Commitments were made to have GP surgeries open seven days, something that would require a massive increase in GPs and resources that won’t be produced by the funding accompanying this commitment. The funding for general practice in England has slumped to just 8.5% of the total NHS budget.

Shortages in GP trainees accompanied by GPs retiring early

The question remains: how do politicians who call for a fully functioning 8am to 8pm, seven days surgery or 48-hour access target, expect to resource it, when we can hardly afford its current model, and when demands are being made to take a further £30bn from the NHS budget by 2021 as efficiency savings?

These measures will only increase demand culture and fail to take into account the available resources, investment and flexibility that will be needed to achieve this.

While workloads are rising, wages have been chipped away, and, are now at the lowest levels since 2003. Morale is low, especially in general practice and emergency medicine, the pressure is becoming too much, sparking a recruitment and retention crisis. The combination of rising patient demand and declining resources has created an emergency that could see many surgeries close.

We truly, have a workforce crisis, with shortages in GP trainees accompanied by GPs retiring early. It takes five to eight years to train a GP and yet all the parties are promising thousands more in the next few years. Practically, this is not possible.

It was disappointing that during the leaders’ debate there was no mention of the pressure on GP services from the seven leaders. Even the so called newer parties didn’t mutter a word on the subject.

An injection of realism is necessary to stop the destruction of general practice. Forcing reform after reform, or chasing spurious projects, can only aggravate the low morale of its workforce. Politicians need resisting, promise after promise rolled out from the podiums, each more lavish than the last and ever more detached from reality. Politicians of all parties, need a reality check, to take a breath and stop playing games with our health services. The BMA campaign, No More Games, tells them all to jettison the nonsense promises and instead have an open, honest debate. We need to safeguard and protect our NHS, and that means addressing the challenges rather than making promises designed to capture media headlines.

  • Dr Chand is BMA deputy chairman but is writing here in a personal capacity.

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