Bringing GP services ‘into the fold’ would ‘finally complete the NHS’, according to former health secretary Lord Ara Darzi, who has suggested all GPs should be given the right to NHS employment.
The independent GP contractor model is ‘frozen in time’ and ‘cannot keep up with today’s demands’, he argued in an opinion piece for the Financial Times.
In the piece, Lord Darzi called for GPs to be welcomed ‘on the same terms as those working in hospitals’ in order to ‘finally complete a joined-up, unified NHS’.
And he said his ‘big regret’ from his time as health minister under the Labour Government between 2007 and 2009 was ‘our failure to persuade GPs to change the way they work’.
The current model of general practice is not set up to deal with patients with multiple, long-term health conditions, and the current state of population health ‘demands modern “hub” facilities complete with routine diagnostic capabilities’, according to Lord Darzi.
He said: ‘Keeping GPs separate from the rest of the NHS is an impediment to reorganising care to meet today’s needs. Offering GPs a right to NHS employment would be a big step forward, as the IPPR recently proposed – and the Labour party has recently backed.’
Lord Darzi, who led an influential national review of the NHS, High Quality Care for All, during his tenure as a health minister, said in the FT that NHS reform is necessary in order to achieve quality care, since ‘to stand still is to fall back’.
He said: ‘Yet some aspects of the health service appear to have been frozen in time. Chief among them is keeping general practice at arm’s length.
‘Most GPs are private contractors and not NHS employees – an arrangement central to launching the NHS in the post-war period.
‘But that model of general practice cannot keep up with today’s demands.’
Lord Darzi also suggested that the current model is worsening GP burnout and, therefore, retention, since ‘without the best new interventions at their fingertips, GPs are having to run ever harder to keep up with demand’.
The surgeon, who holds the Paul Hamlyn chair of surgery at Imperial College London, proposed the a similar idea in 2018 as part of his Institute for Public Policy Research (IPPR) ’10-point plan for the 2020s’.
He said at the the time that the independent contractor model had in some cases hindered the move to primary care at scale.
There had been some confusion over Labour’s position on the GP partnership model earlier this year, with shadow health secretary Wes Streeting offering conflicting opinions.
However, last month party leader Sir Keir Starmer made his position clear when he said the GP partnership model is ‘coming to the end of its life’ and that the NHS needs ‘more salaried GPs’.
Last week GP leaders at the BMA wrote to the Labour Party, urging a discussion in a bid to change this position on the future of the partnership model. The RCGP has also said it ‘strongly resists’ moves to abandon the GP partnership model.
In April, a major Government review by former health secretary Patricia Hewitt recommended a ‘new framework’ for GP contracts, since ‘national contracts’ present a ‘significant barrier’ to local innovation.