Dr Chaand Nagpaul, chair, GPC
GPs care immensely about our patients, and feel dismayed by the constraints impacting on services and undermining our ability to do the best for them.
The GP service is under unprecedented strain, and is unable to meet the needs of a growing ageing population and the increasing volume of care moving out of hospitals. GPs are working beyond their capacity, seeing a record 340 million patients every year, up by 40 million compared to 2008. Demand on GP services has far outstripped supply.
A commitment of more GPs will be vital towards meeting the demands on general practice. However we must first address the challenge of getting more doctors to choose to become GPs at a time of falling recruitment and increasing numbers retiring early.
The figures speak for themselves. A fall of 15% in the number of doctors training as GPs last year, and 451 training places unfilled. We need to address the root causes of this if there is to be any prospect of increasing GP numbers.
We are already working with NHS England on the best way to create the right environment to make general practice an attractive and rewarding career and whoever is in government next year needs to make this a priority.
With the NHS facing a perfect storm of rising demand and a £30bn funding shortfall, patients and the public need to see a detailed, meaningful plan from politicians on how they will create a sustainable infrastructure and capacity in general practice to deliver on current and future needs.
Dr Maureen Baker, chair, RCGP
This announcement is a clear and impressive response to the crisis currently engulfing general practice, and will be warmly welcomed by many GPs and practice nurses across the country.
We at the RCGP have been saying for many months now that unless urgent measures are put in place, general practice as we know it faces extinction, due to soaring patient demand, plummeting resources and a mass exodus of clinical staff.
Today’s announcement, if translated into action, would help to pull general practice back from the brink of disaster and pave the way for a revitalised and refreshed GP service.
We are particularly pleased that this announcement is part of a wider package that includes the recruitment of more practice nurses, district nurses and home care.
We welcome Mr Miliband’s announcement today and look forward to working with all the political parties to discuss how general practice can be properly funded to provide excellent patient care in the community, thereby alleviating pressure on our hospitals.
Dr Peter Swinyard, chair, Family Doctor Association
It isn’t credible. There isn’t that much money in taxing big houses, those are lots of limited pots of low value. It is very much typical Labour tax and spend sort of politics. The thought of spending money on the health service – absolutely fine – but I think he has got to be open about where he’ll get his money from and I think from what he has been saying today his spending promises are bigger than his tax raising promises, so I am not sure the money is there.
I am not sure what the timescale for that is [for the 8,000 new GPs], or where these GPs are coming from. If it is a ten year plan, then am I being terribly cynical if I say that is going to be accounted for then after he has left office and he can’t be held accountable for it. The way to get more GPs is not just to announce that we are having them.
The Conservatives have already announced 5,000 more GPs so Labour has trumped them and said ‘we’ll have 8,000 more GPs’. I think it is just pie-in-the-sky and no one is saying where these GPs are going to come from. How are you going to stop existing GPs from retiring early – that is the biggest problem instantly. How are you going to make life easier for those serving general practice and how are you going to encourage more people to actually train as GPs, which takes much longer of course.
Dr Michael Dixon, president of NHS Clinical Commissioners and chair of NHS Alliance
I think it’s good news, as is the current Government’s commitment to getting general practice to 50% of doctors, but the issue is not so much numbers but how do we make it a job people want to go into in the first place.
So alongside more GPs I’d like to know a bit more about what the plans for investment in general practice are, particularly premises and how we are going to make it a job people want to go into in the first place.
We need more infrastructure and resources to support us – that’s partly about people, but it’s partly premises and it’s also about getting rid of some of the bureaucracy and red tape around DESs and QOFs and enabling us to be professionals, which a lot of GPs feel they can’t now.
That’s why a lot of doctors want to go into hospital medicine now because, oddly enough they feel they are less tied down than in general practice.
Whereas when I went into general practice 30 years ago it was a job you went into because you valued autonomy but now that’s not what we’ve got.
So, it’s good news we can have more GPs, but we need to know a bit more about extra resources in general practice generally and also a bit more about how we make the job one that people want to go into in the first place. And also how we keep those that are about to retire – 35% of the workforce are over 55, so there’s no point making 8,000 GPs if everyone is leaving as soon as they possibly can.
Professor Clare Gerada, former RCGP chair and head of NHS England’s London primary care clinical board
I am delighted – it is important that if we are going to have a sustainable NHS we address the GP workforce issue. GPs keep the NHS safe, accessible and value for money. More GPs and primary care nurses are needed – spending longer with their patients and communities to improve the health and well-being of our patients and populations
I have no doubt that rather like in the 90s, general practice is the profession to be in. It’s tough at the moment being a GP, but it will get better. We’ve got many more opportunities and the future is around primary and community care. So I say, ‘hang in there’ because I don’t think any doctor in any specialism is having a great time of it at the moment.
There’s some urgent action that needs to be taken around workload, we need to address the additional and bureaucratic workload GPs have at the moment, including preparing for CQC, all the DESs and LESs – but I think if you then look at the short, medium and long term, there are enough bright people within primary care, secondary care and the NHS organisations that can find a way through this.
Overall this is good news. It has to be translated of course – but it’s good and it’s concrete. And I suspect all political parties will want to invest in primary and community care because it’s the only way of sustaining the NHS.
Professor Chris Ham, chief executive of The King’s Fund
Ed Miliband’s announcement on increased funding for the NHS shows politicians are now acknowledging the scale of the financial problem facing health and social care. Labour’s commitment to transform the way care is delivered, not just to focus on the immediate funding crisis, is welcome and points towards putting health and social care on a sustainable footing in the future.
The gap in NHS funding can’t be solved in isolation from social care. The recent Barker Commission report recommended a single ring-fenced budget for health and social care adequately funded by a rise in health and social care spending to 11-12% of GDP by 2025 – broadly comparable to current expenditure on health alone in many other countries.
A combination of a mansion tax, tobacco levy and tax avoidance initiatives alone will not fill the growing funding gap. Today’s announcement is a significant step forward but we will need to see Labour’s spending plans in full before we know whether they will be enough to meet the funding gap.
The Barker report looked at the different options available to increase funding for a combined health and social care budget and suggested that a range of measures from a review of wealth taxes, changes to prescription charges and national insurance increases could all play a part. These are hard choices while the public finances are still recovering but they cannot be ducked in the lead up to the general election.