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Keogh: GPs 'undervalued by the NHS at a time we need them the most'

GPs have been 'undervalued' by the NHS at the time when they are most needed, NHS England's national medical director has said.

In a lengthy statement in NHS England’s board meeting last week, Sir Bruce Keogh painted a picture of how GP funding and income has declined while responsibilities have increased and are continuing to pile on further.

At the same meeting, NHS England chief executive Simon Stevens admitted primary care professionals have suffered financially as a 'direct effect' of secondary care providers running deficits.

Referencing the GP Forward View, Sir Bruce said that 'by focusing on general practice and primary care we bring benefits to our patients' and that this was 'the end game in all of this'.

'The reality is that the best way of looking after our patients in the community, is by looking after our GPs and our primary care. And that is true both for our current patients and for our future patients,' said Sir Bruce.

In his statement, he acknowledged a number of points which Pulse and GP leaders have highlighted for a long time, including GPs dealing with an increase in demand from both patients and policy makers while tackling rising levels of bureaucracy and staff shortages.

Sir Bruce said: 'As patients have been moved out of hospital to be treated in the community, we have seen a commensurate requirement for the professionalism of GPs who have increasingly become the general physicians, the consultant community physicians of the day. That is a very important change in my view.

'Yet at the same time, I think there is evidence that our GPs have been undervalued by the NHS at the time when we need them most and when we are asking for them to do more.'

Sir Bruce pointed out that there is 'an inequity' in that 'we have seen levels of investment down by 0.8% annually in general practice whilst it has risen in hospitals by 12.3%', adding that GP take home pay had also suffered.

He said: 'Their income has dropped very significantly in real terms since 2005/06. During a similar period the number of consultations, of increasingly complex patients, has gone up by 14% and there are a set of expectations which have accompanied that.'

Mr Stevens also acknowledged the inequity in how GPs have picked up the slack from elsewhere in the system.

He said: ‘We have been in a period when in effect individual organisations, individual hospitals were choosing their deficit and then expecting somebody else to pick up the tab, given that we live in a nationally budgeted system and Parliament sets the amount of money that the NHS gets to spend each year. And the consequence of that has been that somebody else, namely mental health services and primary care, have been suffering as a direct effect.

 

Readers' comments (26)

  • *checks date - not April 1st.

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  • Yea, we know all that. What are you going to do about it? If nothing changes , you`ve got to resign !

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  • Less talk. More Action.
    show me the money. SHOW me the MONey. SHOW ME THE MONEY!

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  • And does NHSE listen? No...hospitals always come first....meanwhile General Practice falls apart....NHSE's answer is to federate GP practices.....where is the evidence that this will improve productivity, morale or income?....quite the reverse....

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  • Put up or shut up!

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  • Stating the obvious but doing nothing

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  • Actually the money is not the problem (though taxes and MDO fees are extortionate), it's the endless NHS bureaucracy, the bullying GMC and endless entitled-demanders that have done it for me. AW8 in progress, then byeeeeeeeeeeeeeeee!

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  • Look - Who is talking - the most overvalued manager of the NHS.

    And do not forget 'the' MR HUNT.!!

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  • So what are you going to do about it . . . We're waiting and have been for a long time

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  • It's as if he has suddenly made a world shattering discovery- that's what is so infinitely irritating about this. Every so often one of them pipes up with this and then nothing ever happens. General practice detiorates a bit more. Experienced GPs retire early - so many have gone in my area and if its hospital avoidance that you want then it was that cohort who could have really been doing it. Not rocket science just wilful blindness. So Sir this and that if you mean what you say make an impact within 3 months and then I just might treat you with some respect.

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  • Vinci Ho

    Bank of England and Superman Mark Carney probably did not imagine they had to make such a big gamble like today : a massive quantitative easing (QE) buying 60 billions government bonds and 10 billions corporate bonds . Simply put , print more money . The determination to remain as the 5th largest world economy is apparent. Confidence of the market , hence investment , is like the mind of a teenager, easily distracted and unpredictable. The written response from the Chancellor is intriguing but with no giving away of what trump card he is holding. We all have to wait until the budget in autumn to find out about government borrowing and spending . Until then , one can only watch the response of the market and hence the economy . That clearly will govern , to some degree, how and what PH will present his first Chancellor's budget . One thing for sure , it has to be different from what Ozzy was doing for many circumstantial reasons.
    Until then, whatever these NHS executives as well as Agent Hunt said would be just noise at the end of the long dark corridor , rather meaningless . Perhaps , some 'easy-listening music' is harmless to us......

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  • Increasing the pay is a reduction in income....more tax more superannuation more national insurance more tax on pension. Give me less work less expectations less political nonsense less demands more time off work and improve my morale and mental resilience and i will stay.
    nope that is not going to happen. All this is is words and no action. The black holes of acute trusts are the political must saves at all costs to the rest of the local nhs economy

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  • It is quite extraordinary that cocooned apparatchiks in London discover the importance of General Practice intermittently, then do nothing.

    This man must be judged on his record, which is pretty dire.

    Fine words butter no parsnips.

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  • Keogh = Captain (un)Credible

    Don't tell me. Show me.

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  • I do not claim to have any knowledge of how to manage anything , but even I can see that if you undermine and devalue your front line, then everything upstream will suffer. The partnership model gives unreal value for money. Destroy it at your peril. I suspect this awakening is too late for many.

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  • AND.....................

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  • All GPs are fed up of this broken unsustainable system. All talk no real funding.Tax payers are robbed of their rights by poor NHS management funding lifestyle choices, summer houses when basic medicines and surgery has to be cut.

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  • I like a pat on the back - same as any dog (sbody) and I will dutifully wag my tail . Any chance of a biscuit ?

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  • Words and no action. In fact that NHSE is allowing trusts to partake in enhanced services for flu jabs etc just flies in the face of these words.
    And that is exactly what it is WORDS AND NO ACTION. 56 and going. Been a gatekeeper for far too long especially when others are climbing over the fence.

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  • it's bit like a burglar raiding a house then posting a letter to the owners sympathizing about the high crime rates in their area.

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  • I just hope that GPs can see that a cut in funding of 50% in NI [ as an example] from 11% to 5.5 % for GPs with an increase workload is deliberate.
    I am an ass, a donkey that works more and more for less. Look what chairpeople of Inquiries make per year [ they only work a few weeks]. Look at legal aid.
    We are abunch of nitwits taking all the workload and the abuse that Mr Hunt's penance throws at us.
    But who should stand up but our chiefs ?
    Oh, they are away in the other camp getting gongs.

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  • Wake up guys, we know how Sirs are made - it's not always substance that counts. It's how much you pay for the election campaign. That is probably why the titles don' always go hand in hand with integrity and intelligence. If you can become a Sir by just doing hair of former PM's family members, I'd be damned if I respect any titled persona in future.

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  • really?!!!
    you don't say?!
    I am shocked by your insight..what a genius!....pity the overpowering evidence of this has been building for over a decade and obvious to a medical student..pity NHSE has failed to have such wonderful insight before multi billions have been wasted due to failure to invest in primary care and enormous quantities of GP skill have been thrown away retired or emigrated due to the astoundingly imbecilic mismanagement of the NHS for the past decade.
    in the name of GOD!
    apologies I suspect you mean well and have tried but you are part of a disastrous bureaucracy that has profoundly failed this nation.

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  • I am sorry but I feel you should have resigned for your part in the desperate debacle of the consultants and gps in hospital training's contract.
    sorry.
    that was not acceptable in my view.

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