Today the NHS celebrates its 69th anniversary, but it now faces one of the most difficult periods in its history. This Government’s policies and privatisation agenda mean the NHS and general practice in particular will be gone for ever. The way this NHS is being managed by Jeremy Hunt and the government is a stunning example of how not to do things. The roadmap of its policies is leading to the complete destruction of the time tested model of traditional general practice in England.
I believe it will be a completely different primary care system in next few years – one which will be much worse in terms of access, equity, health outcomes and cost. What we are left with is confusion and uncertainty. In so many areas the NHS is at a crossroads. It now faces a recipe for indecision which could harm the service and those it serves. Cuts in the name of ‘efficiency savings’ have eaten away at the NHS to the point where it is down to its bare bones. We have got to the point where the efforts of the NHS family to prop up the system are no longer enough to keep the system afloat. The government is deliberately setting up the NHS to fail, that’s clear. The whole agenda of the Jeremy Hunt & Co is to wash its hands of the NHS. The biggest evidence is that they are starving the NHS of the funding it needs so that eventually they will say that it’s unaffordable.
The general practice model of the past 69 years could see revolutionary changes. We might begin to see GPs working as part of a broader non-acute sector, in larger teams, in different settings, and for new employers, under new ‘Accountable Care Organisations’ and Sustainability and Transformation Plans. A new tier of physician associates is planned, along with more nurses and pharmacists. These skilled non-medical professionals could be allowed to take on the bulk of work traditionally only associated with GPs. All of this would be unrecognisable to a GP from 1948. Primary care is undergoing some significant and worrying changes that demonstrate a lack of value placed on the quality of general practice. The Government appears to be determined to move from traditional GP partnerships to ones where the private sector would play a much greater part in the future structure and running of general practice, with a salaried model.
The current changes being imposed across NHS primary care are leading to the meltdown and eventual destruction of general practice in this country. Private sector providers want to de-professionalise and down-skill the practice of medicine in this country, so as to make staff more interchangeable, easier to fire, more biddable, and above all, cheaper.
The failure to acknowledge the crisis facing GP services – an under-resourced, over-stretched shell of their former selves, struggling to keep pace with patient demand despite the efforts of their staff – could finish off general practice, the ‘jewel in the crown of the NHS’, for good.
General practice is the bedrock of many NHS services and the gatekeeper to the rest. The BMA and RCGP need to unite and confront the realities facing practices and make plans now to fight this politically motivated assault on primary care and reverse the crisis facing general practice – or we can bury our heads in the sand and watch this key part of the health service slide into terminal decline. If general practice fails, the whole NHS fails.
On the NHS’s 69th birthday we need to re-commit to its founding principles and general practice’s importance to healthcare provision and the survival of the NHS.
HAPPY 69th ANNIVERSARY NHS, WE WILL KEEP FIGHTING TO SAVE IT !
Dr Kailash Chand is a retired GP from Tameside and is Honorary Vice-President of the BMA
