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GP recruitment failure threatens NHS vision

The Government's failure to recruit enough GPs is in danger of wrecking plans for a primary care-led health service, a Department of Health report has concluded.

The NHS Modernisation Board's account of progress against the NHS Plan found GP recruitment was way behind the Government's target to recruit 2,000 new GPs by 2004.

Between September 1999 and March 2002, GP numbers rose by just 483. Some 82 GPs have also been recruited from overseas.

'GPs are proving to be the most difficult group to recruit and the service faces a huge challenge to recruit the additional 2,000 GPs it needs to achieve target numbers by 2004,' the board concluded.

'Shortages of GPs and nurses with specialist skills are constraining the potential of primary care to deliver more locally available NHS services.'

Dr Ian Bogle, chair of the BMA council and a member of the modernisation board, said the NHS Plan target would not be met.

'However you look at it the figures are poor,' he said. 'We are a year off and 1,500 short and we must ask why. The delivery of a primary care-led NHS is dependent on having sufficient numbers of GPs.'

Professor David Haslam, chair of the RCGP, said the new flexible careers scheme and developing more GPs with special interests would help recruitment.

But he criticised the Government for rejecting retention payments for older GPs in the contract negotiations and added that even if the recruitment target was met, it would fall well short of the 10,000 increase in GPs the NHS needs.

'Even if the target is met, there still needs to be a lot of flexible working to get some practices to survive the workforce crisis,' Dr Haslam said.

The number of GPs in training rose by 500 between September 1999 and September 2002, against the Government's NHS Plan target of 550 more GPs in training by 2004.

Some 650 GPs with a special interest are now in place, compared with a target of 1,000 by 2004.

Progress against NHS Plan targets

Target Progress

GP recruitment ·2,000 more GPs by 2004 ·483 recruited to March 2002, possibly 700 by September

·1,000 'special interest' GPs by 2004 ·650 in place

Premises ·500 one-stop health centres by 2004 ·184 completed by September 2002

·3,000 practices improved by 2004 ·1,325 GP surgeries replaced or substantially refurbished

Access ·100 per cent of GPs to offer appointment ·84 per cent of GPs achieving target; 99 per cent of

in 48 hours by 2004 those in the collaborative

Coronary heart ·Cut heart disease death rate by ·14 per cent reduction since 1998

disease 40 per cent by 2010

Smoking ·At least 1.5 million smokers to ·April 2000 to December 2002 ­ 250,000 quit

quit by 2010 after four weeks' cessation help

Cancer ·Urgent referrals seen within two weeks ·Target achieved in 98 per cent of suspected cases

Source: NHS Modernisation Board

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