Posted by: Nigel Praities Editor's Blog7 April 2017
The Government has a nasty habit of painting GPs as either heroes or villains to suit ministers’ needs.
Earlier this year practices were blamed by the Prime Minister for increasing pressure on A&E by closing in core hours. Newspapers accused the profession of ‘clockwatching’, demanding GPs open up ‘when patients want’.
A measure to punish errant GPs who brazenly use lunch breaks to grab a sandwich on the way to some mandatory training or a home visit was included in the new GP contract. ‘Open or lose cash’, is the threat.
We are not even close to stabilising general practice
Now, seemingly with a straight face, the Government is portraying GPs as the solution, asking them to staff a new ‘front door streaming’ service at all A&E departments by the end of the year. This, ministers’ logic goes, will enable emergency departments to focus on urgent cases – completely glossing over the fact they’ve just ordered GPs to stay in their practices and open longer during the day.
There’s more. Just last month, ministers told NHS England to start work on ensuring same-day GP appointments for all over-75s (as promised in the Conservatives’ election manifesto in 2015). Add the pressure to continue rolling out David Cameron’s seven-day access wheeze and you start to wonder whether ministers are ‘gaslighting’ the profession.
The truth is that some of the Government’s ideas are good. The evidence is mixed, but you could see a GP triager would be ideal to sort the life-threatening from the trivial at A&E front doors. Similarly, I know no GPs who would not like to offer frail elderly patients better access, or who would balk at running the odd evening surgery for commuters.
But the problem is we are operating at a time when numbers of GPs are actually falling. Ministers like to trumpet the fact we have record numbers of trainees studying general practice, but even if you include these, overall numbers are down. We are nowhere near the mythical 5,000 extra GPs promised by 2020, not least because so many GPs are cutting their hours or leaving altogether.
Even the chief executive of NHS England – a man I am repeatedly told ‘gets’ the workload avalanche crushing GPs around the country – told a parliamentary hearing that managers will be collecting data on GP waiting times this year with the ‘reasonable expectation’ that access should improve as money from the GP Forward View materialises.
But as we show today, one year on we are not even close to stabilising general practice; closures continue at record levels and some towns are uncomfortably close to having no practices able to take new patients at all.
Even simple measures, such as telling hospitals to do their own work, are not being policed. The money from the GP Forward View will barely keep the profession pedalling, never mind attempting the Tour de Extended Access.
All the time, ministers are playing to the gallery, boosting patient expectations, desperately trying to show they have a grip on the situation and are able to spray GPs all over the country at will to solve the NHS’s problems.
They don’t and they can’t. And they need to stop pretending otherwise.
Nigel Praities is editor of Pulse