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The waiting game

My prediction for the coming decade? More of the same

Editor’s blog

By happy coincidence for opinion writers, a new Government has taken office just as a new decade begins, meaning predictions for the years ahead can double up as predictions for the new administration.

Unfortunately, I see nothing to suggest that these next few years will bring anything different for GPs.

I do genuinely believe the Government has finally woken up to the reality of general practice that GPs – and, to an extent, NHS England – have known for years. Ministers know there is a workforce and workload crisis. They know the austerity years have left premises unfit for purpose, IT systems lagging way behind where they should be, and the money on offer for partnerships insufficient to tempt GPs into the role.

They have committed £4.5bn of investment over five years, which – while not exceptional compared with pre-2010 levels of funding – is at least a reversal of the disastrous austerity years that barely saw any uplift.

But I fear they are repeating the mistakes of the past decade. Whenever funding has been found, it’s been linked to new work and this time is no different. Yes, there has been investment in networks, but look at how much is expected of them from this year. As Copperfield tirelessly points out, networks will be tasked with providing enhanced care home provision, delivering CV prevention and diagnosis and ‘tackling neighbourhood inequalities’. Not to mention, of course, extended hours routine care.

I see nothing to suggest that these next few years will bring anything different for GPs

Imagine a minister telling firefighters they’ll only get the resources to put out fires if they also start filling potholes. Yet being unable to put out fires is where GPs find themselves now.

We can also spot the same old mistakes around increasing GP numbers, with a handful of small initiatives ministers believe are sufficient to attract thousands more doctors to enter and stay in English general practice.

The Conservatives’ plans to increase GP numbers by 6,000 by 2024 include: reducing bureaucracy for those wishing to practise in the NHS (welcome but unlikely to have much effect); using technology to reduce workload – a slightly fanciful aim; and promoting networks to make general practice more attractive. These hardly foster confidence.

The NHS People Plan, on workforce, and GP access review are due soon and may well have sensible proposals. But again, these are unlikely to increase GP numbers by the necessary amount.

And even if general practice was rescued by well-targeted, radical proposals, I fear the NHS would remain at best stable. Because the rot is widespread. As our cover feature notes, many young people’s mental health services accept referrals only for the most serious cases. Thresholds for treatment are increasing in many other areas of care, public health cuts hamper genuine efforts at prevention, and the future of social care looks bleak.

However, I don’t want to start the year on a sour note. So here is my prediction for 2030: the NHS will be in such a state that politicians and the public alike will grasp the need to manage expectations. We’ll ditch DNA testing, seven-day routine services and pointless checks, and realise our health service can be great if it is allowed to treat sick people. However, that might be a fanciful notion too. Happy new year!

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at

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Readers' comments (7)

  • National Hopeless Service

    And it needs to treat sick people not fungal toe nails, acne, ingrowing toe nails and the plethora of non threatening rubbish we are forced to see and treat daily.

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  • "But I fear they are repeating the mistakes of the past decade."

    - Yes, but for not being honest about the truth of comprehensive unsustainable socialist healthcare provision. We should be tailing the NHS back, not throwing more money to be frittered away on useless "managers, CQC, initiatives like 7 day routine access, religious circumcisions up in Scotland, personal health budgets, the list goes on"

    Jaimie, you never seem to engage on this point. Betrays your political leaning. I had presumed the Editor of Pulse should be politically neutral?

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  • Agree with Christopher Ho. Above is deluded, over optimistic waffle.

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  • Chris, if I may,
    why would the editor of Pulse be politically neutral??
    Are the editors of the Mail, Telegraph, Times, Standard (formerly Tory Chancellor) entirely politically neutral??
    Are Any of us?
    We can't say that the right wing free marketeers are under-represented in our media, can we?

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  • |DrDeath | GP Partner/Principal|19 Dec 2019 3:06pm

    You would hope that neutrality would be the objective, although I grant you that there is a very thin line between journalist and activist. Very few people are politically neutral personally of course, however, surely as part of the professional role of any editor of a media stream, would be to maintain as neutral a position as possible, to appeal to as wide an audience as possible(?), amongst other aims. But maybe I presume too much. Jaimie has pretty much declared his position anyways, but feel free to correct me if I'm mistaken.

    On the representation in the media, oh I certainly think there is a left leaning bias in the "mainstream" media, and that's before we go into other things like state education, social media "deplatforming/censorship", etc.
    Just look at the report done on the BBC re its bias.
    When's the last time you saw a report/documentary on Venezuela, or the Yellow vest movement in France, or the Hong Kong protestors, on mainstream media? You'd have to go to independent media/alt sources...

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  • Whilst I agree that a lot of money is wasted on pointless initiatives not to mention PFI/tendering etc I'm not quite sure how Christopher Ho envisages a "tailed back NHS". Is it one where those that can afford it get decent healthcare whilst those that can't get something very basic? Like the USA, which spends almost twice a much of GDP on healthcare as the UK? Where medical bills are reported to be the number one cause of bankruptcies. The OECD has compiled data on dozens of outcomes and process measures. Across a number of these measures, the U.S. lags behind similarly wealthy OECD countries (those that are similarly large and wealthy based on GDP and GDP per capita). In some cases, such as the rates of all-cause mortality, premature death, death amenable to healthcare, and disease burden, the U.S. is also not improving as quickly as other countries, which means the gap is growing.

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  • My prediction for the coming decade? More of the same
    Might be that´s not that bad... It can be:
    My prediction for the coming decade? Even worsening... in what decade will we reach the buttom?

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