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Keogh: GPs ‘undervalued by the NHS at a time we need them the most’



GPs have been ‘undervalued’ by the NHS at the time when they are most needed, NHS England’s national medical director has said.

In a lengthy statement in NHS England’s board meeting last week, Sir Bruce Keogh painted a picture of how GP funding and income has declined while responsibilities have increased and are continuing to pile on further.

At the same meeting, NHS England chief executive Simon Stevens admitted primary care professionals have suffered financially as a ‘direct effect’ of secondary care providers running deficits.

Referencing the GP Forward View, Sir Bruce said that ‘by focusing on general practice and primary care we bring benefits to our patients’ and that this was ‘the end game in all of this’.

‘The reality is that the best way of looking after our patients in the community, is by looking after our GPs and our primary care. And that is true both for our current patients and for our future patients,’ said Sir Bruce.

In his statement, he acknowledged a number of points which Pulse and GP leaders have highlighted for a long time, including GPs dealing with an increase in demand from both patients and policy makers while tackling rising levels of bureaucracy and staff shortages.

Sir Bruce said: ‘As patients have been moved out of hospital to be treated in the community, we have seen a commensurate requirement for the professionalism of GPs who have increasingly become the general physicians, the consultant community physicians of the day. That is a very important change in my view.

‘Yet at the same time, I think there is evidence that our GPs have been undervalued by the NHS at the time when we need them most and when we are asking for them to do more.’

Sir Bruce pointed out that there is ‘an inequity’ in that ‘we have seen levels of investment down by 0.8% annually in general practice whilst it has risen in hospitals by 12.3%’, adding that GP take home pay had also suffered.

He said: ‘Their income has dropped very significantly in real terms since 2005/06. During a similar period the number of consultations, of increasingly complex patients, has gone up by 14% and there are a set of expectations which have accompanied that.’

Mr Stevens also acknowledged the inequity in how GPs have picked up the slack from elsewhere in the system.

He said: ‘We have been in a period when in effect individual organisations, individual hospitals were choosing their deficit and then expecting somebody else to pick up the tab, given that we live in a nationally budgeted system and Parliament sets the amount of money that the NHS gets to spend each year. And the consequence of that has been that somebody else, namely mental health services and primary care, have been suffering as a direct effect.