Javid admits Government will fail to fulfil GP workforce election pledge

Health secretary Sajid Javid has admitted the Government will fail to fulfil its election pledge to recruit 6,000 additional full-time equivalent GPs by 2025.

Speaking at a hearing by the House of Commons Health and Social Care Committee, Mr Javid told chair Jeremy Hunt ‘I don’t think we are on track’ when asked if he believed the Government would meet its target.

He said the Government is trying to tackle the GP workforce crisis by lifting the cap on medical school places in 2020 and 2021, resulting in a ‘record number of students in medical schools’. 

Mr Javid also referenced ‘the importance of international recruitment’ to drive up GP numbers.

He added: ‘I would like to see [the Government get on track], certainly, and look at what more we could do. We definitely do need to and I want to see that increase, but I’m not going to pretend that we’re on track when clearly we’re not.’

Back in May this year, a BMA survey showed well over a third of GPs (36%) were considering early retirement within the next 12 months due to an increasingly overwhelming workload, and more than half (51%) said they were likely to reduce their hours.

Analysis by the Nuffield Trust also confirmed the Government is set to miss its 2025 recruitment aim. 

It found that although the GP headcount in England had risen by 1,385 since the 2019 general election, when this promise was made, the number of full-time, fully qualified GPs had decreased by 105.

Mr Hunt pointed out that as health secretary, he did not meet his own GP recruitment target to have 5,000 more GPs by 2020 due to ‘a big increase in the number of GPs going part time or retiring early’, and asked Mr Javid: ‘How do we stop history repeating itself?’

Mr Javid said: ‘Whether a GP or not, people have a right to whether they move to part-time, or in some cases they might retire earlier than otherwise. And I think part of the answer… is that we’ve got to make sure that we are listening to what can help GPs and also their general work environment, the unimaginable pressures.

‘I think pre-pandemic we wouldn’t have thought about this kind of pressure on our primary care clinicians, including the GPs, and we’ve got to look at what other ways we can support, it’s got to be about investment in recruitment as well.’

He added that ‘for those that do want to work extra hours, and if that’s a question of some extra funding or some other changes, it’s important we provide that as well’, pointing to the £250m GP winter access fund.

‘That was partly put together because a number of GPs and their representatives came to us, and they said that there will be some GPs that can work some extra hours but you have to be able to fund it properly, whether they’re locums or there’s other types of support.

‘So it’s not all about funding, by no means it’s all about that, but it’s about looking at the whole spectrum of things that we can do to help.’

It follows NHS England suggesting the access fund could be used to bring in retired secondary care doctors, including geriatricians, to help boost appointment numbers.

When pressed by Mr Hunt on how many extra doctors and nurses are needed to clear the elective backlog, Mr Javid said he ‘can’t put a number’ on the amount.

Mr Javid added an elective recovery plan is due to be published at the end of the month, but there will be no NHS workforce strategy published until spring next year.

Mr Hunt criticised the GP access package when it was announced, saying it would ‘fail to turn the tide’ on existing GP workforce issues.

At the committee hearing today, Mr Javid also told MPs he ‘doesn’t know’ if GPs should receive a larger share of the NHS budget.

Dr Luke Evans MP asked the health secretary: ‘Broadly speaking, the figures roughly show 9% of the NHS budget goes towards general practice in which they see about 90% of the population. Do you think that figure is right, given the pressure they’re under?’

Mr Javid said: ‘I don’t know, to be honest, at this point. I don’t know.

‘I think certainly what we need, especially now in light of the lessons we’ve learned through this pandemic, is a transformative approach for how we deal with future health challenges, the demand on health care, the waiting lists, the elective backlog, mental health.

‘And I think that does mean a fresh look at how does primary care work with secondary care, work with community hospitals, work with people in the community, with midwives, and to take a fresh look at all that.’

Dr Richard Vautrey, BMA GP committee chair, said: ‘While the health secretary’s admission today is long overdue, it is absolutely not news to GPs and their colleagues working in surgeries across the country that have been decimated by workforce shortages. The bottom line is we are haemorrhaging doctors in general practice. Whilst more younger doctors may be choosing to enter general practice, even more experienced GPs are leaving the profession or reducing their hours to manage unsustainable workloads.

‘A failure to show any meaningful support for GPs or efforts to retain experienced doctors – something completely absent in the Government’s recent ‘rescue plan’ that has been overwhelmingly rejected by the profession – ultimately impacts how easy it is for patients to access their GP practice. Instead of merely recognising that this target won’t be hit, the secretary of state should do something about it – and his recent actions threaten to make the situation far, far worse.’

Professor Martin Marshall, chair of the RCGP, said: ‘It isn’t surprising to hear that the Government are not on track to keep their pledge of 6,000 more GPs by 2024 – this has been clear for some time – but it is disappointing.’

He added: ‘The college has consistently been raising the alarm about the intense workload and workforce pressures facing general practice – and the impact it is having on patients – while the Government focuses on ‘sticking plaster’ solutions to address them that do not address the fundamental challenges. It must ramp up efforts to meet its promises of 6,000 more GPs and 26,000 more members of the wider practice team as a matter of urgency.’

Last week, Chancellor Rishi Sunak pledged £5.9bn to the NHS, which includes funding for digital technology and tackling the backlog of care.

Notably, there was no mention of the 6,000 extra GPs in the budget, however despite this the Government did reiterate the goal to boost GP appointment numbers by 50 million.

The BMA said the money must be ‘matched by a workforce to deliver’ it.

The goals to boost GP numbers and appointments by 2024/25 had been a Conservative Party election pledge in 2019.

The news comes as the BMA has opened a ballot asking GPs what action they are prepared to take against the Government’s access plan.