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Guest editorial: GPs must address suspicions of politicians head on

Guest editor Dr Sam Everington argues GPs must embrace transparency and challenge those who do not invest in their practices, if politicians are to trust them with new resources.

Guest editor Dr Sam Everington argues GPs must embrace transparency and challenge those who do not invest in their practices, if politicians are to trust them with new resources.

Pulse invited Dr Sam Everington, former deputy chair of the BMA and a GP in Tower Hamlets, east London, to be our guest editor for the week.

He set the news agenda and commissioned a series of opinion pieces and features centred around his chosen theme - the stark funding inequalities within the NHS, and what GPs can do to overcome them.

Dr Michael Dixon, in his debate piece this week sets out the seriousness of the problem GPs face. Stories in the Daily Mail about our pay, and widespread ill-feeling within Whitehall, SHAs and PCTs, have led to a great reluctance to invest in primary care. Yet my experience is of GPs working harder – way beyond European legal limits – and a primary care system that is severely under-resourced.

GPs are finding it difficult to cope with the workload while preserving what patients value most – the time to talk to their doctor.

I see GPs passionate about their work and hugely committed to their communities, but struggling to access the resources they need. NHS Tower Hamlets, where I work, recognised the under-resourcing of general practice and asked independent experts to assess our funding needs. Their analysis showed a need for a 40% increase. Yet this message in some ways could not have come at a worse time. PCTs are planning for

a substantial reduction in income while shifting work into primary care under Care Closer to Home. Some of the solutions lie in addressing the inequalities in primary care funding. While campaigning against inequity, Professor Aneez Esmail and I uncovered problems wherever we looked. Pulse this week does the same – revealing stark inequalities across the board.

Over the past three years, secondary care funding has risen by 30%, but primary care funding by only 14% – against a backdrop of practices taking on an increasing proportion of consultations. There is an 18-fold variation between PCTs in enhanced-service investment. And in one trust, the proportion of reinvestment by GPs in their practices varies by more than two-fold. At policy level, as in academia, the acute sector dominates. GP leaders are often hugely outnumbered by specialists. I struggle to count 50 professors of general practice, compared with thousands in acute medicine.

My practice has shared its accounts with the PCT for five years – building up trust and a supportive business relationship. We need to offer transparency to ensure our outliers in income and performance do not dominate politics and are not used as an excuse to avoid investing in the rest of us. We need a new deal with the NHS that allows us to address inequalities, maintain all that is good in general practice, but gives trusts certainty that any investment goes directly to patients.

Dr Sam Everington is a GP in east London and integrated care lead for NHS Tower Hamlets.

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