GPs deliver 10 demands to rescue primary care

By Gareth Iacobucci

GPs are demanding the end of patient survey pay targets, swingeing cuts to Darzi centre contracts and a halt to the creeping fragmentation of primary care, in the biggest test of the profession's opinion in the run-up to the general election.

Overwhelming numbers of GPs responding to Pulse's election survey also wanted to see opportunities thrown open to women and young doctors, and a new deal struck with the Government to ensure the profession is properly resourced for its ever-expanding role.

Pulse this week launches a 10-point Manifesto for General Practice demanding an end to medicine as a popularity contest, pledging to fight threats to GPs' clinical autonomy and calling for cuts to focus on waste rather than front-line services.

Pulse will use the manifesto to highlight the concerns of GPs to key politicians and policy-makers in the run-up to the general election.

Our manifesto, which distils the detailed responses of nearly 900 GPs to our survey, comes as we uncover worrying evidence of the current direction of NHS spending priorities as trusts respond to the financial crisis:

• In Oxfordshire, calculations by the LMC suggest a GP-led health centre opened last year is costing £140 per consultation – five times more than neighbouring practices.

• In NHS West Kent, the PCT plans ‘strengthened market management' of mental health services, declaring: ‘The mental health service can be provided at lower cost' and admitting that services are ‘likely to be reduced in some areas'.

The strength of feeling among GPs is laid bare by our survey – with 82% supporting cuts to Darzi centre contracts, and a similar number wanting reductions in spend on management, to protect patient services.

There is also disquiet at the convenience culture in the NHS, with 78% of GPs calling for the patient survey to be scrapped as a means of payment, and almost two-thirds believing increased use of community specialists is fragmenting primary care.

Of the various means of generating NHS efficiency savings, only a third of GPs said they believed referral management schemes were appropriate.

And GPs are alarmed by the slew of hospital work heading their way, with 79% saying the Government and BMA should agree a reiteration of the principles of the GMS contract, including no new work without new resources.

Dr David North-Coombes, a GP in Chertsey, Surrey, said ‘drastic expenditure cuts' should be achieved by giving GPs greater autonomy: ‘Concentrating on good patient care should free us to do our work with less oppression and reduce need for expensive managers.'

Dr Peter Swinyard, a GP in Swindon and chair of the Family Doctor Association, urged the next government to focus on ‘simple moves to save cash and focus on patient care', including: ‘drastically pruning PCT and SHA staffing, developing strategies for continuity of care and encouraging practices to take on partners and upskill nurses'.

A series of clinical organisations threw their weight behind Pulse's manifesto. GPC chair Dr Laurence Buckman said: ‘The principles cover many issues we have also been pushing.' The National Association of Primary Care and the NHS Alliance backed many of our demands.

Pulse will focus on each manifesto issue in turn as well as providing free election badges to help GPs highlight the issues.

Please click here to pledge your support, order campaign badges and read the full election survey results.