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Dr Chaand Nagpaul: '11% of funding for general practice isn't an arbitrary target'

Dr Chaand Nagpaul, chair of the GPC, responds to comments made by the BMA chair that GPs’ calls for 11% of the NHS budget are ‘artificial’

I think 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.

Ten years ago, 10% of the NHS budget was spent on general practice and we are now seeing a significant move of care into the community. Every political party, every government across the four nations, are totally committed to expanding care in the community, so it should not seem odd to suggest that general practice should receive an increasing share of the budget.

It isn’t so much an end in itself so we mustn’t get hung up on the actual percentage - it may be more than that. But the fact is that 10% of the budget was spent on general practice ten years ago and in that ten years we have seen an absolute escalation, a massive sea change of care being provided in the community and it will continue to do so. So I don’t think it is unreasonable to exprct that level of investment.

What we are seeing is a huge level of expense in hospitals as a result of general practice infrastructure not being able to manage patients effectively in the community because we just don’t have the GPs or the facilities.

So there is a compelling argument that investment in general practice and community services working together will be the key to achieving cost efficiencies.

The figures speak for themselves when you pause and reflect that a GP is given just over £73 for seeing a patient an unlimited time, 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.

Dr Chaand Nagpaul is chair of the GPC

Readers' comments (1)

  • Totally agree with Dr Nagpaul. Clearly though this exposes a rift between the GPC and the rest of the BMA where powerful voices are already screaming about the lack of resources to secondary care. Secondary care has had resources but delivered in such a way as to cause that money to be lost to the system eg winter pressures money- rather than invested where it can give back a return. Government, not clinicians can largely be blamed for this. However, I am afraid that one of the reasons General Practice is in such a parlous state is because the boys at the top of the BMA aren't prepared to fight for General Practice in a world where there is no more money in the pot- regardless of whether it is 'fairer' or not.
    Of course it is right for GPs to have a bigger share of the funding if there is to be ANY hope of the NHS remaining sustainable as GPs are the only ones in the system who can have a realistic impact on secondary care use. But we must also argue for more money for the NHS as a whole. The best way to argue for more Dr Nagpaul, is to know what it is we deliver. We need to do a lot more work to describe and cost what it is we as GPs do and why we are such good value for money.

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