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GPs buried under trusts' workload dump

GPs 'can't abandon their contracts with the NHS', says Hunt

Health secretary Jeremy Hunt has said that GPs have an 'obligation to follow their contracts', following calls from local GP leaders for the BMA to support vulnerable practices to go private. 

Mr Hunt was responding to a question about the motion set for debate at next week’s England LMCs Conference, first reported by Pulse, which called for practices to be 'supported to operate within a private, alternative model' if they feel they can no longer operate within the NHS.

Speaking to MPs on the Commons Health Select Committee, the health secretary said practices' 'contract with the state' was their principal source of income, so they have a responsibility to look after NHS patients.

Responding to a question on the motion, Mr Hunt said: 'I would listen to everything that came out of any BMA conference carefully but the Government makes policy on the NHS, not the GPs, and they do have an obligation to follow the contracts that they have.

'But obviously if there is concern about the levels of workload and about the capacity of the system then that is something that I am going to listen to very carefully.''

Labour MP Ben Bradshaw - a former health minister himself - asked Mr Hunt: ‘[GPs] are private contractors aren't they and you couldn't just stop them [abandoning the NHS]. Does this not show how bad things have got to that GPs are even considering en masse abandoning the NHS?’

Mr Hunt responded by saying the Conservative Party had wanted GPs to be NHS employees when the NHS was set up in 1948.

He added: 'The point I am making is, yes they are private contractors but they also do have a contract with the state which is the source of their income, and we have a responsibility under that contract to look after all NHS patients in the area they operate.'

Explaining the pressure GPs are under, Mr Hunt said: 'I think we have to look at the underlying reason why those kind of motions are being debated, and I think it is GPs feel that their workload is too high, their job has become too stressful. Sometimes they feel that they are on some sort of hamster wheel of between 30 and 40 ten-minute appointments every day, and it is exhausting.

'The long-term solution to that is to get more capacity into the system, which is why we have our plan to recruit 5,000 more GPs which we are in the middle of trying to deliver. Some bits of that plan are going well, other bits less well, but I am absolutely determined to deliver that and I think that is the long-term solution.'

He added that he hoped GPs had taken from recent announcements he had made that this was 'an area of great concern for the Government as well and we are taking a number of measures to try and relieve the pressures on general practice'.

Explaining to the committee how he was working on resolving the GP workforce crisis, Mr Hunt mentioned both the recently unveiled state-backed indemnity scheme, and the expanded incentive scheme to get GP trainees into areas that have found it difficult to recruit.

At the same hearing, Mr Hunt said NHS was struggling financially because demand 'has grown faster' than the Department of Health 'had anticipated', linking growth in emergency services demand to ‘underinvesting’ in general practice.

Mr Hunt said: ‘We can do an enormous amount to bring down demand for emergency care. In the ambulance service we have 4,400 999 calls more every day than we had in 2010, that creates massive pressure on the emergency services.

'One of the reasons for the pressure is we have underinvested in general practice in recent decades, and have underinvested in the kind of community care, so that would mean that people would not get to the point where they have to dial 999 and additional expensive hospital care. That’s what the whole sustainability model is about.’

 

Readers' comments (35)

  • Vinci Ho

    Mmmmmm
    Send your comments now

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  • National Hopeless Service

    And the Jeremy came to the earth and spoketh of reality and truths. Hallelujah they doth shout.

    But then Mother Theresa (May) and Jeremy did b#gger all about it.

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  • We have "an obligation to follow our contracts" but he can change them at a whim!!

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  • All these other private companies seem to be able to hand contracts back to the NHS.

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  • Finally we have his attention. We can hand contracts back en mass Mr Hunt. Just like the dentists. We can go. I hope when this is debated next Friday, the LMC set a deadline and targets (NHSE will like those) which must be met before we all leave. And then, finally, I may have a career.

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  • Vinci Ho

    The truth is the last thing a politician would want to tell only because the circumstances give him no alternative.
    For our representatives:
    Examine carefully the reasons behind this behaviour before any further negotiation.
    And remember it is only a fine line between negotiation and extortion. Question only resides on who is the extortioner and who is being extorted? There is no mercy in politics and remember how merciless the enemy has been on us .....

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  • Dear All,
    What rank hypocrisy, what contract or agreement has Mr Hunt ever stuck to? CCGs only too happy to terminate PMS contracts and how many new GMS contracts have they let in the last x years, oh that'll be a zero.
    Regards
    Paul C

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  • Oh yes they can

    I did and it feels so good

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  • AlanAlmond

    The NHS does not own me. I am not a slave. I will work for whoever I choose. If an NHS contract obligates me to sacrifice my sanity, welfare and entitles the government to parasitise me at will, I will walk away and give the finger as I do, could anyone blame me for doing so?
    The problem the government has is that it imposes it’s contracts, often without negotiation. It feels it can do this because it holds a virtual monopoly on employment through the NHS. Treating those you impose contracts on like shit is not conducive to a longer term working relationship. We (GPs) need to leave the NHS, regain our professional integrity and end this nightmare of bondage to successive parasitic governments.

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  • Let's see if the great and good of our profession will lead us in a rousing chorus of OH YES WE CAN. I won't be holding my breath.

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  • GP’s only have an obligation to look after the NHS patients in an area only while they have a contract with the NHS!
    Mr Hunt a) knows that most GP’s cannot afford to go private because most patients would not be willing or able to pay privately and certainly not for the range of services that NHS general practice provides and b) most GP’s do feel obligated to their patient population and will hang on to the bitter end.
    Hence his smug smile.
    He is stretching goodwill to the limit!

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  • How many times have I said it? Until there are resignations in mass numbers in an area, nothing will change. To those hanging in there... do everyone a favour, including yourselves, and resign....

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  • Well said MacDonalds , it’s the cardigans that hold us all back. Vote Leave 👍

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  • I thought we were all still serving penance for a rise in 2004

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  • Mac med - spot on. It's not easy to walk away from a principal GP post. I did. But it took me a good 6-7 years to build my "ark". Only a small minority make it out. A small number of GPs contribute to these comments sections. The vast majority will stick it out. Formally educated people are naturally selected to conform - that's precisely how we got through the hoops we needed to.
    I'll tell you what will happen, right here and now - NOT MUCH.

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  • It is the governments obligation to provide health care for its citizens...... it is up to individuals whether or not to work within the health system the government creates. Yes we have to follow any contract with this sleezy government, which can unilaterally change things at the drop of a hat, if we accept their contract, but they can't stop us from emigrating. Mr Hunt is wrong, the state is our source of income.....I agree, but only if we agree to work for it. I don't. My main source of income is the Australian tax payer. There are Canadian tax payers, Kiwis, all sorts who could become our main source of income. The fact they are even talking about mass resignations in UK government is progress, the danger is if GPs don't act quickly to follow through on this they will attempt to legislate to stop GPs from doing just that. We need areas to fail to give this the national publicity it needs.

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  • anon2016 suggests that not much will happen: and I agree with him -- it won't happen actively. But without a doubt it will happen (passively), because there will come a point in every professional's life when he/she simply won't be able to cope any more and will then resign.... leaving his/her patients in the abyss.
    I have said for decades that we won't save the NHS if we refuse to go on strike. No-one will listen until it's too late and by then General Practice will have collapsed permanently. What we always needed to do was to stand up to the the NHS political bullies and give them a very firm ultimatum... and then walk away from the NHS if nothing happens.
    Sadly, it's almost certainly too late now.

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  • what will happen is what is happening. Doctors will gradually give up and drift away until there are not enough left to do the job. Then what will he do?

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  • the health secretary said practices' 'contract with the state' was their principal source of income, so they have a responsibility to look after NHS patients.

    WHAT IF, WITH CURRENT FUNDING AS IT HAS BEEN FOR A DECADE, AND IS LIKELY TO REMAIN...
    THAT IT WERE NO LONGER A GPs PRINCIPAL SOURCE OF INCOME?

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  • A contract is an agreement between 2 sides. This contract allows unilateral changing yearly! We are fed up and we want out.

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  • All we need is few brave souls to leave NHS and set up successful private practices.Currently many GP are rightly scared of post NHS scenario (staff redundancy/ overhead / mortgage). When few practices will show the way that it is possible exodus will begin.
    Then we can dictate our prices If government wants our services.
    So we need to suffer more till some of us to become bit more brave and jump this sinking ship

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  • Under investment is only but one reason Jezza. It is the paperwork, work load, bureaucracy, passing all the social work risks to us, encouraging complaints, interfering with our work and you stoking up the demand and cutting the beds at the same time that is the problem.

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  • Dr Gund

    Fight fight fight .....and VOTE LEAVE ! The Titanic is sinking.... 🚢NHS⬇️

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  • 'GPs can't abandon their contracts with the NHS' says Hunt.
    Mr Hunt- I am a fervent supporter of the NHS and want it to continue for the benefit of ALL people in this country.
    However part of the problem at the moment is really that the likes of you get away with spreading shite like this. This is simply not true- who gives you this information or do you just make it up in your head?

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  • I assume that the vast majority of people who used a "private" service would be exempt from any fees , under 18s, over 60s, unemployed etc. etc. So very little would change other than penalising the squeezed middle.

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  • In the past private GPs were definitely able to refer patients to secondary care through the NHS. I am not sure if that is still possible. If it is then patients would only have to pay for private primary-care and presumably privately prescribed medication. Patients wouldn’t have to pay for secondary care. If enough GPs become private, insurance companies will develop cover for private primary care.

    My other point is that this just shows how scared Jeremy Hunt is.

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  • watchdoc | GP Partner/Principal01 Nov 2017 1:15pm

    I don’t see why patients over 65, the unemployed, disabled et cetera would be exempt from fees in a private GP service. This only applies to NHS care for medication.. Of course the ideal situation would be for the NHS to part support private primary care and to fully fund the elderly etc, as exists just about everywhere else in the world.

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  • If GPs are private contractors then surely they can leave! And we should simply because he says we can't. I say follow the dentists.

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  • Dear All,
    If you want something to happen get in contact with your local LMC and tell them how you want them to vote at the English LMC's conference next week. They are there to represent your views. If you do not let them know what you are thinking they will vote in isolation. You have the power, use it.
    Regards
    Paul C

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  • Vinci Ho

    I second to that

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  • JH has imposed Contracts on GPs and Junior doctors. An imposed Contract is an oxymoron,there is really no such entity. But he is right, there will be enough ultimate vocational groups who will accept and work under any circumstance, even a 50% cut in funding per contact. There are enough GP trainee places being filled to function in a different multi-disciplinary primary care,with a different and cheaper workforce mix.

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  • He's a cunning toad. When the NHS goes under, wouldn't it be convenient if GPs were to blame? This is an invitation. He knows that the number of GP WTEs is only going down. It's a whole lot easier if GPs jump and take on the risk themselves, rather than HMG having to pay for premises, 37.5 hours/week salaries and indemnity.

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  • Vinci Ho

    Do not underestimate this nuclear bomb called ‘sexual harassment ‘ dropped in Westminster. All MPs from all parties with a ‘past history’ are vulnerable.
    The first casualty is called Michael Fallon.
    The aftershock waves of this earthquake will have implications on the credibility of Westminster and essentially this government.
    Damian Green strongly denied allegations against him.
    More stories will come.
    Watch this space especially for those who are to have any form of negotiation with this government.......
    And of course , the PM is hopeless and helpless in dealing with the crisis in Northern Ireland with no devolved administration established : Good last luck Tom(Black) with all your courageous efforts.....

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  • Unfortunately we all know it's just talk from LMC ad GPC. They are toothless and won't do shit

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  • Paper Tigers,the real leaders are leading the exodus out of the UK and the profession.RELP

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