Top of the agenda for the BMA conference, which began today in Liverpool, was the new government’s promises on seven-day routine GP service that have no basis in reality. I have been at many BMA conferences but I am struggling to remember a gathering where GPs – and the wider profession – have been so angered with a health secretary’s proposals.
As the BMA’s chairman Dr Mark Porter highlighted in his speech this morning, the government is promising patients and the public 12-hour routine opening across all GP services, but ignoring the fact that both the current five-day service delivered by practices and the seven-day GP urgent care service are under massive strain. It’s foolish in the extreme to try to build an extension when the current house is falling down.
It takes 10 years to train a GP – so how are 5,000 going to be delivered by 2020? Even if the health secretary does have a magic wand to radically cut the training programme in half, while retaining clinical safety, this will not address the fundamental problems deterring young GPs from entering the workforce. An overworked, underfunded environment where GP practices are unable to keep pace with rising patient demand is not going to attract the next generation of doctors.
Last year, more than 400 GP trainee posts were left vacant. Our major BMA survey of 15,560 GPs found that one in five GP trainees who had put themselves on the first step of the GP career ladder were now considering working abroad before 2020. With a third of existing GPs also planning to leave the profession in the same timeframe, the government will actually need far more than the 5,000 GPs it magically plans to recruit. As Mark Porter said of the government’s plans: 'Who are they kidding?'
This depressing situation is made all the more disappointing because it is not the case that GPs are opposed to change or indeed working with politicians to address the huge demographic challenges of an ageing population that are bearing down on the NHS. We are working with NHS England, Health Education England and others to make recruitment and retainer schemes simpler and more adaptable so GPs taking career breaks or working abroad can get back into the workforce quicker.
GP premises investment
After years of lobbying by the BMA, we have finally secured major investment in GP premises that will benefit hundreds of practices. £1bn is not enough but it’s a big start in trying to put right the lack of investment in premises over the last decade and more.
We will not blindly and meekly accept a political pipedream with no foundation in reality or clinical need because our patients deserve and expect better. Our patients can see right through the emperor’s new clothes.
Only a few weeks ago a number of CCGs confirmed they were pulling the plug on the PM’s Challenge Fund because of a lack of uptake for appointments on Saturdays and Sundays – on the latter barely 12% of consultations were booked. When the NHS faces a £30bn deficit and practices are closing because their basic funding is being slashed and can’t recruit GPs how can this be a sensible or productive use of precious, scare resources?
The BMA may be being criticised by those who rarely use the health service for its stance, but that will not deter us from speaking up for GPs and for the vast majority of patients who depend on our services. If politicians want to deliver real change they must stop the grandstanding and posturing, and work with us to deal with the reality facing GP services on the ground.