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BMA chair: GPs' arguments for 11% share of funding are 'artificial'

Exclusive A split in the BMA has emerged as the Labour party calls for more funding, with BMA chair Dr Mark Porter saying GPs should not be given a greater share of the NHS budget, Pulse can reveal.

In an exclusive interview with Pulse, Dr Porter said that while general practice does need ‘proper resourcing’ he would ‘not care to nominate’ the other areas of the NHS that would need to give up resources to shift funds into general practice, adding that RCGP and GPC arguments for an 11% share of NHS funding did ‘not go into detail’ of how health services should ‘responsibly’ be funded.

Dr Porter was speaking to Pulse at the Labour party conference in Manchester, before party leader Ed Miliband’s speech, which is expected to outline plans for a ‘mansion tax’ on properties worth more than £2m in order to provide greater funding for the NHS.

The RCGP launched its campaign for general practice to receive at least 11% of the overall NHS budget at the end of last year, after new estimates showed it was receiving just 8.4%, while GPC chair Dr Chaand Nagpaul today reiterrated his comments that the NHS is in ‘danger of collapse’ unless the share of funding given to general practice is increased to 11%.

But Dr Porter criticised the calls for the percentage of funding to increase, stating that this would negatively affect other areas.

He said: ‘I think the problem with thinking in the individual figure is, if you said to me specifically “if the [overall NHS] resource stays the same, should [GP funding] go to 11%?”. Well, if that is the case, the 93% that is available to everybody else, if we assume that figure were correct, then the 93% available to everybody else becomes 89% and that is another 4% worth of cuts elsewhere.

‘Would you care to nominate the areas that they should be cut from? I wouldn’t, and that is why I think there is a little bit of artificiality about campaigning on an individual number that is not based on a specific need. What is unarguable is that general practice needs proper resourcing and that proper resource lies somewhere north of where we are at the moment.’

It comes as Labour leader Ed Miliband is widely expected to announce increased spending on the NHS on the whole, in a speech at the conference later today, as a pledge ahead of the general election next May.

Both the BBC and the Guardian have reported that Mr Miliband will propose that Labour tax increases for the wealthy – including a ‘mansion tax’ on homes worth more than £2m announced by shadow chancellor Ed Balls yesterday, and a tax on tobacco companies – should be used to increase NHS spending, with the BBC reporting that this would by £1bn a year.

However, Dr Porter said that if the next Government did raise the overall NHS resource, then the calls for general practice to receive an 11% share would still be ‘problematic’ because ‘11% would be 11% of a much larger cake’.

He said: ‘That is the problem with pegging to a percentage. It is a good way to have an individual headline but what it doesn’t do is go into the detail of how we should be responsibly funding the service that patients so closely depend on.’

But responding to those comments, Dr Nagpaul said this target was ‘the rightful way’ to ‘manage a pressured health resource’.

He told Pulse: ‘I mean 11% isn’t some arbitrary target in its own right. Ten years ago, 10% of the NHS budget was spent on general practice so we are not talking about something that is an unreal expectation.’

He added that ‘every political party’ was now ‘totally committed to expanding care in the community’.

Dr Nagpaul said: ‘The figures speak for themselves when you pause and reflect that a GP is given just over £73 for seeing a patient an unlimited number of times, including home visiting, for a whole year. How can that not be efficient compared to the fact that about £150 is spent for an average outpatient tariff appointment, one single contact in hospital?

‘I think there is a compelling argument and it is not an argument based on some target, it is an argument based upon recognising the rightful way of managing a pressured health resource.’

Readers' comments (26)

  • With friends like Dr. porter, Who the FUNK needs enemies. This our BMA doing its best, creating unity and looking after its own doctors. Thank god I resigned the BMA 3 years ago. Saving my £400 rather than giving it to unhelpful doctors who are meant to be on our side.

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  • I'm not sure of the logic behind Porter's comments. All the work is moving into the community, surely that should be where the money goes to as well?

    Of course, he also forgets the context of a time of a GP recruitment and retention crisis.

    Either way, his comments lead to two major problems.

    1. He is clearly acutely unaware or uninterested in the problems in General Practice at present.
    2. His comments have large negative impact on the GPC's mandate for GPs, and sabotages Nagpul's own authority.

    Either way, my resignation from the BMA is looking more and more likely. If I retain my membership, I would hope to see some much needed new leadership at the top of the pyramid.

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  • Bob Hodges

    Thus spake the Gas Man.

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  • Without increased funding then we should reject all unfunded secondary care work as they should have the resources to do it themselves.

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  • I suspect Dr last.Watch the NHS collapse Dr Porter when the firewall around hospitial disintegrates.
    When it next comes to renew my BMA subscrition they can whistle.

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  • This comment has been moderated.

  • I see where Mark Porter comes from. TI am not aware of any evidence that 11% of NHS budget to Primare care would make a difference. We need a much higher funding for primary care than at present and 11% of present NHS budget has been a ball park figure by GPC/RCGP. The raison de etre of the 11% would be lost if the total funding shrinks drastically. Also he has to listen to more numerous Hospital doctors -more proportion of which pay BMA fees as robbing Paul to pay Peter doesn`t help.

    That said this is something he should have discussed with GPC and RCGP in private and saying this in public is in my opinion a great disservice to the GPC and the GP`s who are squeezed from all angles with secondary care work being dumped on us.

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  • What isn't artificial is the patients I'm seeing today and I'm booked through to 7.30pm and have just stopped to have a cup of tea; the patients can wait as I haven't had lunch.. Yesterday was 50+ and tomorrow I know not what.
    Any shift in fund should come to me as I'm doing all the friggin work!
    I suspect I am ot alone in this!

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  • I've said it before and I expect I will get countless more opportunities to say it -
    There is never a shortage of doctors willing to shaft their colleagues in public.
    If this is what Porter believes he should have had it out with the GPC in private.

    Never, never, NEVER betray your colleagues in public Dr Porter. This would be a resigning matter for a man of respectability.

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  • To the person above who is waiting for his BMA renewal, why wait? Leave now and save your money. It worthless where you are putting it.

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  • I have no problem telling Dr Porter where the money should come from - the NHS is again overspent, £2 billion less is being spent in primary care, that £2 Billion has gone somewhere, take a look at where budgets have increased and funding has increased, and cut it from all the areas that were happy to increase their resource at the cost of primary care - they've has a few good years out of it, now they can live as primary care has lived, in penury due to their greed and failure to committ to maintaining or reducing their costs!

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