Welsh minister sparks GP anger, telling LMCs there is no workforce crisis

The Welsh health minister sparked anger among GP leaders on Saturday after insisting there was no general practice workforce crisis.

Dr Jones: ‘To us it’s very much a crisis on the ground’
Dr Jones: ‘To us it’s very much a crisis on the ground’

While there were problems in some areas with recruitment, Professor Mark Drakeford (Labour, Cardiff West) told the annual conference of Welsh LMCs, talk of crisis was damaging.

During an otherwise well received speech, Professor Drakeford told GPs gathered at the Celtic Manor resort in Newport, the Welsh government was ‘very aware’ of concerns over recruitment. But problems would not be solved if ‘we constantly talk up the erroneous idea that there is a recruitment crisis. There isn’t. And it really doesn’t help attract people to come to Wales if our slogan is: 'Come and work in Wales, isn’t it awful?'.’

The Welsh NHS currently had the smallest vacancy level, and best retention figures ever, the minister said. And while there were real ‘hotspots’, in certain disciplines and geographical areas, he said, the government, led by the chief medical officer, was addressing those issues.

Practical things government could do, he said, included changes to locum indemnities, the performers list regulations, and expanding the retainer scheme, to make general practice more attractive as a career. 

‘For all the challenges there are’, he added, ‘in the face of those challenges what we cannot afford to do is simply throw up our hands in horror at them… They are not problems that cannot be solved. The hill is not too high to climb.’

But vice chairwoman of Gwent LMC Dr Debbie Waters told the minister she was ‘completely shocked’ by his denial. Research by the Bevan Commission and the Centre for Workforce Intelligence, showed the scale of the problem, she said, and a substantial number of GPs were due to retire: up to 25% in the next five years, and 49% in the next 10 years. ‘At the coalface, there is a huge problem. And it is extremely worrying. So I’m quite shocked to hear you say there isn’t’, Dr Waters told the minister to applause.

But the minister hit back: ‘I simply think that you are wrong’, he replied. GPs were making the problems ‘more difficult to solve’ by portraying the problems as a crisis. ‘We do have problems and we do have difficulties. What we don’t have is a crisis. And talking ourselves into a crisis mentality will make solving those problems harder not easier’, he said to heckling from the floor.

GPC Wales chairwoman Dr Charlotte Jones stepped in to ease tensions, telling LMC representative that ministers and GP leaders were talking about the same problem, but using different language to describe it. 

‘To be fair to the Welsh government’, she said, ‘it is a priority, and there is an awful lot of work going on with respect to attracting medical students into medicine in Wales, also attracting trainee doctors into general practice.’

‘To us it’s very much a crisis on the ground’, she added.

Representatives unanimously agreed motions demanding workforce morale be urgently reviewed and insisting the Welsh government investigates recruitment and retention problems and develop long and short term plans.

The conference also voted unanimously to call on the Welsh government, Local Health Boards, the Deanery and GPC to initiate an ‘urgent action plan’ to address the GP shortage in rural Wales.

Dyfed Powys LMC’s vice chairman Dr Meredydd Owen-Cox said workforce and training problems were ‘worse in rural areas’.

Earlier, Dr Jones opened the conference telling representatives the situation in Wales was ‘unprecedented’, with GPs ‘under strain, demoralised and not seeing any relief on the horizon’.

GPs reported concerns over tick-box medicine, bureaucracy, micromanagement, increasing patient demand, unresourced shift of workload into primary care, and funding cuts, as well as significant recruitment and retention problems, she said.

GPs were disappointed their problems had not been recognized by the Welsh government, she said, ‘as we were not allocated any of the additional monies given to Welsh healthcare in the Assembly budget round this year’.

On the controversial MPIG withdrawal agreed earlier this year for the 2014/15 GP contract in Wales, Dr Jones said ministers had made it clear this was a ‘non-negotiable area’.

The question GPC Wales faced, she said, was whether to walk away, risking imposition and the other gains of a negotiated agreement, or try to mitigate the impact of the cuts.

‘We decided to work on getting as fair a process and as good a deal as we could. To be fair to the Welsh government it was willing to look at an income loss cap of 15% of the correction factor % of global sum equivalent. Whilst any loss to practice income is a strain and we know that this income loss is on a background of reducing monies coming into the practice including enhanced services being decommissioned but the harsh reality is it was going to happen. The average loss per affected practice is £5,000 per year for the next seven years – this is hard and tough but could have been much worse without the protection for the outliers.’

GPC Wales’ focus over the next year would include workforce problems, supporting networks, stability for practices, finding solutions to unintended effects of MPIG withdrawal, and ensuring health boards meet government expectations to move resources into the community, said Dr Jones.

* Look out for more coverage of Saturday's conference here on GPonline.com

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