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To Labour: The point

To Labour: The point

Jaimie Kaffash on Labour’s plans for general practice and why they don’t understand the profession

Frankly, I would make a rubbish politician. I am no fan of ‘horse race journalism’, where politics is treated as a race between two parties, who make strategic plays against one another to get the upper hand. I’d provide far too much substance about any policy on which my opponents could catch me out. I’d ignore polling data and I wouldn’t pay much attention to the front pages of papers that will end up supporting my opponent regardless.

Basically, I would do the very opposite of what the Labour health team seem to be doing. Whenever Labour come out with a policy, I can just picture the focus groups that they tested their policy on, while poring through polling data, deciding if it will be well received in the Mail, or whether ‘Red Wall’ voters will support it, and asking themselves the question of whether it meets that highest standard that politicians can meet – a good old-fashioned, common sense approach. Unfortunately, very little consideration is given to whether the policy is actually any good.

Their latest offering being pushed is their policy for patients to self refer, bypassing general practice. Now, in some circumstances, this might make sense; many would like to book direct with physios, for example. Which they can at the moment, in many areas. But Sir Keir Starmer’s example of patients testing themselves when there is ‘internal bleeding’ suggests that they haven’t really got a clue about how the health system.

We are at a time of unprecedented waiting lists – which Labour have continually pointed out – so I can’t see how allowing patients to self-refer will help.

But, for me, the more important point is a basic lack of understanding of the role of the GP. The most basic function of the GP is the gatekeeper role. They deal with 90% of what they see without referral to secondary care. That’s because their role is to manage undifferentiated symptoms; it is telling the difference between the harmless and the harmful rash, or to decide whether back pain needs a physio or a neurologist. And because GPs filter out most of this for specialists, the specialists aren’t strong on seeing what is harmless. Until Labour understands the role, they should think twice about changing the whole model of general practice.

Instead of developing policy on issues they (willingly?) don’t understand, the party should focus on the overwhelming point about the NHS – one that will, ironically, politically benefit them the most: that the health service is in the state it is as a result of years of austerity, lack of care and fanciful promises by ministers desperate to win the horse race. And not because of NHS staff, as they are trying to portay. Sadly, it feels as though the Labour cavalry have no intention of reversing this rhetoric, even if they do win the race.   

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

Cameron Wilson 19 January, 2023 10:50 am

Question Time tonight should be a good watch. Wes Streeting and Clare Gerada! At least we have a GP on the panel, go get them Clare, no mercy!!!

Christopher Ho 19 January, 2023 3:43 pm

“result of years of austerity,” – misinformation, Editor….

NHS funding going up year on year. What’s our national deficit and debt, Editor? Inflation? Who’s gonna stump up more cash for the totally efficient NHS, you?

Sam Macphie 20 January, 2023 12:18 am

You hear many people claim why can’t we spend more money on this or on that thing in the UK because we are one of the richest countries in the world, which is quite tiring to hear.: perhaps they are mean GDP, however UK actually is not so well off: we have an income per person of something like 27th country in the league table of nations; not so rich after all.
Also, we seem to hear endlessly about bed-blockers,(which isn’t the patients’ fault of course) and how social care needs more funding: it seems there will always be beds that are ‘blocked’, or this issue would have been eradicated decades ago, if this was that easy a thing to do; (and the Blue party certainly have not sorted this out in the last 13 years). The important thing is that the UK needs at least 6,000 more General Practitioners, and the way things are today, we should be training a lot more homegrown medical students in our universities. There are many UK school students who obtain the necessary qualifications, and with the right aptitude, to do Medicine; and the vast majority are likely to remain based in the UK when they qualify. The process of increasing places for home-grown Medical Students should be started immediately on a large scale. Too many keen, caring and qualified British applicants are let down by not being accepted for a place at Medical School. Increase the number of places for UK Medical students at university today: plan for the future with this important first step. The longest journeys start with the first step don’t they. Also, this will improve social mobility within our population which is no minor thing.

Christopher Ho 20 January, 2023 9:49 am

Unfortunately Sam, the stats say otherwise.
There have been unfilled medical school places over the last few years, unheard of in my time. Smart kids are increasingly choosing NOT to study medicine anymore, as they learn of how doctors are treated in the NHS. And if you’re smart enough to be a doctor, you’re smart enough to do something else more rewarding.

Of those we train, almost half are leaving the UK after training, as they rather work elsewhere than in the NHS.

GDP per capita is easily obtained:

And as per my previous point, there is no money to “train more medical students”. I.e debt and deficit. Or are you happy to pay MORE for it via taxes and inflation? Or be the brave one to cut funding to universities for “lesser” degrees? Only the free market can determine the true cost/benefit of doctor numbers.

Slobber Dog 22 January, 2023 2:56 pm

Abolishing the partnership model is all about increasing control of GPs and cost reduction.

John Evans 24 January, 2023 8:16 am

Complex situation – public to a degree are economically ignorant / finding it convenient to be so they don’t have to make difficult decisions.

The uk economy (like some others) is able to support premier league football clubs whose value is now billions. The economy has even made space for whole new tier careers for reality tv and social media ‘celebrities’.

There is no appetite for politicians to educate them on the realities. Hence, the efficiency rubbish gets recirculated with investment in mangers to whip the clinicians struggling to deliver the promises.

We are approaching a critical point. It is just a matter of how the inevitable change of direction will occur. A battered nhs that starts to heal or a CRASHED/dead NHS needing replacement. Sadly, I have no doubt that the us model will be adopted (is being adopted).