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Ed Miliband: 'Ending the 48-hour pledge was a really bad mistake'

Labour’s leader speaks to Pulse news editor Jaimie Kaffash about his plans for GPs

It was like a scene from The Thick of It. Dozens of London politicos milling around a closed hospital cafe, wondering how they ended up in a small town in the West Midlands.

Ed Miliband 330

Labour’s 10-year plan for the NHS will be unveiled the next day in London, but in true Malcolm Tucker-style, Pulse is ensconced at the George Eliot Hospital in Nuneaton with only a three-page summary of the document, handed out 15 minutes before the briefing starts.

But Labour’s health spokesperson Andy Burnham and the big draw of the day, leader Ed Miliband, greet us as if we were long-lost friends.

They are perched uncomfortably next to each other on a sofa, but Mr Miliband is clearly in charge – prompting his shadow minister to cover all aspects of their 10-year NHS plan released 100 days before the general election.

‘As Pulse showed, you’re seeing one in five patients waiting longer than two weeks’

‘I think what people most want from the health service is the sense of a plan, a sense of the vision of the future,’ he says. ‘And I think as well as all the other failings of this Government, they’ve provided no vision of the future, what the NHS looks like.’

It is not surprising that he is keen to speak with us, after all the NHS is a key plank of Labour’s election strategy and he needs GPs onside to deliver one of his major pledges  - a guarantee of a GP appointment within 48 hours.

‘I understand the anxiety there is about any changes that happen but I think it’s been pretty much shown by experience that the Government’s decision to get rid of the 48-hour standard was a really bad mistake,’ says Mr Miliband.

But is he not worried that it will bring back the daily lockdown in the morning as patients scramble for appointments? Mr Miliband references a Pulse survey that showed long waiting times for GP appointments published last year and the 8,000 more GPs he plans to fund if he is in power from May.

He says: ‘The problem is it meant there’s no proper backstop for when people get seen and as a result, as Pulse showed, you’re seeing one in five patients waiting longer than two weeks. You just need to look at the attendances at A&E – the rise in attendances – to see the problem.’

‘We said two things about this – one was to recruit more GPs and it’s important to make sure that’s deliverable and secondly get rid of some of the frankly ridiculous bureaucracy and competition regulation which is costing money, and saving that money applying it back into GP services.’

As well as removing competition rules, Labour also plans more radical change to the NHS to promote much greater integration. The 10-year plan includes plans to create a ‘year-of-care’ tariff for those with complex needs, such as frail older people, which will cover all of a person’s care costs over a year.

Mr Burnham explains that this will mean a ‘home to hospital’ service  with hospitals – and perhaps GP practices - being given the opportunity to extend into primary care, employ GPs and provide more social support.

He explains: ‘An organisation like [the George Eliot Hospital] wants to grow into the community, wants to become an integrated care organisation so that’s the future that we’ve got to offer and that’s what the plan will allow.’

But will GPs want to work for large ICOs as salaried employees? Mr Burnham explains: ‘It’s about saying that if younger GPs  in the early part of their career want to work for an integrated care organisation then that is something that I think we would encourage.

‘I’ve met a group of GP trainees in Manchester recently who said: “We don’t want to become partners in a practice straight away, we want to work differently. We’d like a more salaried position to begin with and maybe go into partnership later on in our career”.

‘We understand that general practice is under incredible pressure at the moment. We know morale is very very low. We will work at this with the profession. But this is about, a truly preventative NHS needs the best possible primary care and the commitment we’re making is part of that.’

And the morale of people working in the NHS is clearly important to Mr Miliband. He announces that there will be a new ‘staff champion’ in the NHS that will feed back on how the workforce is feeling – although it is unclear if this person will represent GPs.

‘The NHS is facing a perilous moment’

He adds: ‘I met some folk who work here earlier on just on the corridor they just happened to be there – they basically maintain the machines in the hospital and they do repair work and so on and they were incredibly proud to be working in the NHS and I said to them: ‘What do you think people are feeling about the NHS at the moment?’ and two of them said together: “Fearful.”

‘I think the reason for that is because people feel like the NHS is facing a perilous moment and there needs to be a sense of plan for its future and I think that’s what we’re providing tomorrow.’

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Readers' comments (23)

  • Bob Hodges

    It's almost as if someone has painstakingly removed any evidence any fingerprints that might suggest that someone in the Labour Party has actually spoken to any qualified GPs before coming out with this.

    I'm so disappointed that politicians have yet again gone out of their way to take the kernel of a good idea and twist it into something that is quite frankly 'batsh*t mental'.

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  • No. I think what most people want from the health service is good and timely care - not "a sense of a plan".

    "pretty much shown by experience that the Government’s decision to get rid of the 48-hour standard was a really bad mistake" - whose experience?

    "You just need to look at the attendances at A&E – the rise in attendances – to see the problem" - one cannot assume cause and effect. Even if there were a rise in A&E (which I thought was in doubt) this would need to be considered along with an increase in GP workload plus any increase in the population. Moreover, those patients we keep hearing about who go to A&E because they will be seen within 4 hours will not be happy even with 48 hours.

    "get rid of some of the frankly ridiculous bureaucracy" - how many times have we heard this from politicians before the next onslaught of bureaucracy and regulation hits?

    "you’re seeing one in five patients waiting longer than two weeks" - does this include patients with entirely non-urgent problems who prefer to book ahead?

    "I’ve met a group of GP trainees in Manchester recently who said: “We don’t want to become partners in a practice straight away, we want to work differently. We’d like a more salaried position to begin with and maybe go into partnership later on in our career"" - how's that career plan going to pan out when we are all salaried employees of large IOCs?

    ‘We understand that general practice is under incredible pressure at the moment. We know morale is very very low. We will work at this with the profession" - will you? How? That would involve talking to normal GPs before formulating your plans, not afterwards.

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  • Let's give Grommet a chance . I know he's only a fictitious dog but he seems to have more of a grip on things than the politicians .

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  • The guy is completly clueless...it's like he's held a few policy meetings, 'brainstormed' a few ideas that he's run through a focus group and chatted to a couple of GP trainees and hey presto ...' The labour party 10 year plan for the NHS'

    He is indeed as clueless, remote and 'born, bred and raised into a political family in a reasonably nice part of London ' as he appears.....clueless...and sad the prospects of the country as a whole.

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  • Leaving the Country ASAP...

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  • I am deeply disappointed that 48 hour access is a key part of Labour's Policy. . We ( like most other practices) always have some same day urgent slots ( and scope to see urgent extras following telephone triage) so people can see their GP based on need. This means we can continue to provide advance booking too. In the days where we had to offer automatic 48 hour access , it was much more difficult to manage access overall, and ensure continuity for patients with non acute problems. MANY problems do not require 48 hour access ( routine prescription reviews and long term condition checks to name just two) . Many patients want the choice of pre-booking to see their preferred doctor for non acute problems.

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  • I gathered recently that the LMC regards 70 consultations per 1000 patients per week as a reasonable standard of service for general practice. Defining standard of service by that sort of criterion makes more sense than setting a target for maximal wait. Maximal wait for a patient with severe pain or sudden breathlessness needs to be in hours, while for a cosmetic skin rash it can justifiably be more than a week.
    Having GPs work for a care organisation that is led by a single hospital trust will deny patients choice of hospital, and increase referrals as trusts dumb down primary care and impose guidelines to maximise referrals in order to maximise income from items of service.

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  • Electing Ed milliband as labour leader was a 'really bad mistake.'

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  • Why is he so obsessed with 48 hrs access? It destroys continuity. I remember those days. Patients would come in twice for the same thing. We need more money, and some respite from GP bashing, constant change and over-regulation. In one month our practice has had a CQC inspection and a quality review meeting with CCG. Both looking at totally different things. I despair.

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  • " I despair". ........says it all really.

    "and two of them said together: “Fearful.”.."....... I simply do not believe that two repair men would use the word " fearful", let alone that they should say it together. It's the kind of word Ed would use but smacks of a made up story to fit his agenda. As long as politicians manipulate, don't listen, and chose carefully selected facts which fit their own agenda I will not have any faith in them.
    I also despair.

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