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Gold, incentives and meh

If we let struggling practices fail, general practice could fail

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What an irresponsible statement from an NHS England director, allowing struggling GP practices to ‘fail and wither’. This is totally unacceptable. Simon Stevens, the CEO of NHS England has repeatedly said: ‘general practice is the cornerstone of the NHS’ and ’if general practice fails the whole of the NHS fails’. I hope he reprimands the managers with the mindset that they can let practices fail and immediately releases enough emergency funding to rescue such failing practices.

General practice is not just in crisis, it’s imploding

If the present administration believes that it can starve general practice into submission and bring in private providers to take over, it will be mistaken too, as the first priority of private companies providing NHS care is to ensure a profit for their shareholders. Because of huge funding and workforce crisis, the general practice is no longer a profitable enterprise for the private sector. And anyway, by that time it will be too late for primary care to be rescued and care will be much the poorer (and more expensive) for it.

I have been a be a frontline GP for 30 years. I did go to dark side, and was PCT chair, then I was deputy chair of the BMA, and am now chair of Northwest BMA. It’s been a roller coaster journey, but very interesting one. What I have experienced is that politicians from all sides share two worrying traits: glossing over the enormous problems facing the NHS and a tendency to promise voters what they cannot deliver.

The reality is that a GP surgery is shutting its doors every 10 days on average and the closures will become daily within a year. Soaring demand, cuts to social care, deteriorating workforce, increasingly complex workload and lack of funding has led to a toxic mix where existing GPs cannot wait to leave and young doctors will not join. The pressure on general practice has reached new heights and GPs are drowning. They can no longer cope and are forced into drastic action by closing.

The BMA has raised fears that the high average age of GPs, the poor work/life balance and the increasing workload could result in as many as 500-600 GP surgeries closing as GPs take early retirement or choose to leave the profession altogether. There has been a five-fold rise in the number of GP surgeries approaching senior NHS managers for advice about shutting their doors or merging with nearby practices. GPs’ ever increasing workloads – not helped by the denigration of the profession by media and politicians – is bringing about a recruitment and retention time-bomb. This crisis is a microcosm of bigger problems the NHS is facing due to political mismanagement of healthcare.

General practice is not just in crisis, it’s imploding. Recently, Jeremy Hunt said general practice is ‘the jewel in the crown of the NHS and central to the future of the health service’. It is high time he put his money where his mouth is, and gave GP practices the resources and capacity to meet the challenges that are threatening to overwhelm the entire service, and not let struggling GP practices fail. If these practices fail, we are in danger of killing traditional general practice.

Dr Kailash Chand OBE is a retired GP and former deputy chair of BMA council. You can follow him on Twitter @kailashchandobe

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Readers' comments (3)

  • Couldn't agree more!. Simon Stevens is part of the problem not solution. Since he has been the CRO, the funding in real term has gone down not up!GP practices are closing. Young drs. do not want to take over practices. They only work as locums. Fully trained drs. are electing to go into financial sector and earn a great deal more.
    By training more drs. will mean many will migrate or go into other professions. The current dispute with Junior drs. is not good for the future.

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  • The DoH/Government has utterly failed in its duty to provide even the most basic of succession planning. They have known about the capacity timebomb of upcoming GP retirements for years and simply failed to make any plan. They then compound this with a myriad of bodges and tweeks which just makes it worse. If we ran our practices the way DoH/Govt. runs the NHS we'd be shut by the CQC. WHEN IS THE CQC GOING TO CARRY OUT AN INSPECTION & REPORT ON DoH/Govt.?

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  • Spot on,Steve!

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