He has pledged to boost funding by at least £8bn extra a year by 2020 and to create a truly seven-day NHS. The government is also promising to recruit 5,000 new GPs, in today’s Queen’s speech. Where’s the cash? Where will those 5,000 extra GPs come from? How can politicians deliver 5,000 extra GPs in the next five years, when we are expected to lose 10,000 GPs retiring in the same period?
£8bn extra (we don’t know where this is coming from) for NHS still leaves £22bn of impossible efficiency savings to fill the £30bn spending gap. Health secretary Jeremy Hunt told the King’s Fund that the £8bn will be found from cutting the budget of other government departments. The obvious difficulty is that while the NHS is in dire straits financially, social care is being bled dry. This further compounds the problems for the NHS in general and general practice in particular.
New government needs a reality check
The GPs I talk to tell me. that they are perplexed as to how they are supposed to provide an 8am to 8pm service when they can’t even provide enough appointments during a standard working day. Our political masters and NHS England have taken a one dimensional approach to extended GP services by focusing on cost and getting more from GPs for the same or even less money.
The new government needs a reality check and needs to understand that what GP services need is a long-term, stable plan that gets them back on an even keel. This means better funding and a sensible recruitment plan, and also a wide-ranging look at how we can support new services in general practice and release the experience and potential that GPs and patients have to shape services locally. I fully endorse GPC chairman Dr Chaand Nagpaul ‘s plea to the prime minister ’to jettison the political pipedreams of tomorrow and get real about how we resource, resuscitate and rebuild general practice today’.
Nobody disputes that access to GP services needs improving, but prioritising weekend and evening access at the cost of access and services during normal hours is neither right, nor desirable. Access has got to be need based, and GPs must be allowed to tailor their services according to local demand.
An injection of realism is necessary to stop the decline of the general practice. Forcing reform after reform, or chasing spurious projects, can only undermine the objectives of this ‘jewel in the crown of the NHS’ and the morale of its workforce.
The decrease in GP funding in the name of efficiency savings has eaten away the primary care sector to a bare bones existence. Promises do not help. Face the realities. We have a long and hard struggle ahead if we are to restore the general practice to its previous glory. First and foremost we need to restore the morale of the GP workforce and not flog them to death.
Dr Chand is BMA deputy chairman but is writing in a personal capacity