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The 2024 contract won’t be the revolution we were hoping for

The 2024 contract won’t be the revolution we were hoping for

Editor Jaimie Kaffash on why the prospect of a general election next year is bad news for GPs holding out hope for radical change in the 2024 contract

You might be wondering why we haven’t covered any of health secretary Steve Barclay’s speech at the NHS Confederation Expo today. It’s because there was nothing whatsoever of substance. 

We may need to get used to this. With a general election likely late next year, and one the Government will almost certainly lose, any announcements will be either manifesto pledges for 2025 or meaningless initiatives.

This is bad news for GPs. Because in the meantime, we have negotiations for the 2024 GP contract in England, set to begin soon for an April implementation. The 2024 contract has been trumpeted – and no more so than by us – as potentially the biggest revamp of the profession since 2004, when the responsibility for out-of-hours care was effectively removed from GPs. But the timing could not be worse.

As all GPs in England know, there needs to be a huge revamp of the profession – we can’t continue as we are. This might be in the form of removing a chunk of work, increasing funding to match 2004 real-terms levels (when general practice was arguably at its most healthy), or trying to reduce demand rather than stoking it through promises around choice that they can’t keep.

It is highly unlikely that this Government would engage in the long-term thinking or committing to the extra funding necessary even if it was in a position of strength. But with a general election around the corner, such thinking will be as likely as Boris Johnson showing some humility.

In fact, the biggest danger now is that the Government will be looking to make major changes – because their priorities won’t be aligned to GPs’. They won’t be looking to make the profession look enticing for new recruits from 2025 and onwards. They won’t be looking to reduce burnout, or care that piling on extra work in the short term will lead to major negative long-term consequences by accelerating resignations and retirements. Their only priority will be to show the reactionary press that they are on the patients’ side by making GPs work harder and tackling their apparently obscene earnings by imposing more draconian contractual requirements and cutting funding.

I don’t think this worst case scenario will bare out, however. I think what will happen is that the current contract will roll over in an uneasy limbo, where everyone is waiting for Labour to come in and implement their ideas. I have not hidden my concerns around Labour’s health plans – but I would say that, were they to win the election, at least they will be able to think slightly longer term, which can only be a benefit.

When this happens is anyone’s guess. If there is an election in next summer, it will be too late for a revamped contract for 2025-26. So for those of you still remaining in the profession, don’t be expecting major change any time soon.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at



Please note, only GPs are permitted to add comments to articles

David Jenner 15 June, 2023 8:30 pm

Well of course , if no concessions on workload or finance perfect timing for industrial action if GPC can sort themselves out .
Mass resignation of PCN DES ( or threat of with intent to carry through) actually requires no ballot as it is a contractual flexibility . Even if GPC cannot get their act together, this would throw a spanner in the works before the election ( likely autumn , not summer 2024)

Finola ONeill 16 June, 2023 8:58 am

With you on that David Jenner. Seems a simple plan and simple plans are best

Steven Douglas 17 June, 2023 7:03 pm

‘funding to match 2004 real-terms levels (when general practice was arguably at its most healthy)’

General practice was in a crises state then with poor recruitment (though not as bad as now)!
This was why the out of hours commitment was removed.