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My prediction for the coming decade? More of the same



By happy coincidence for opinion writers, a new Government has taken office just as a new decade begins, meaning predictions for the years ahead can double up as predictions for the new administration.

Unfortunately, I see nothing to suggest that these next few years will bring anything different for GPs.

I do genuinely believe the Government has finally woken up to the reality of general practice that GPs – and, to an extent, NHS England – have known for years. Ministers know there is a workforce and workload crisis. They know the austerity years have left premises unfit for purpose, IT systems lagging way behind where they should be, and the money on offer for partnerships insufficient to tempt GPs into the role.

They have committed £4.5bn of investment over five years, which – while not exceptional compared with pre-2010 levels of funding – is at least a reversal of the disastrous austerity years that barely saw any uplift.

But I fear they are repeating the mistakes of the past decade. Whenever funding has been found, it’s been linked to new work and this time is no different. Yes, there has been investment in networks, but look at how much is expected of them from this year. As Copperfield tirelessly points out, networks will be tasked with providing enhanced care home provision, delivering CV prevention and diagnosis and ‘tackling neighbourhood inequalities’. Not to mention, of course, extended hours routine care.

I see nothing to suggest that these next few years will bring anything different for GPs

Imagine a minister telling firefighters they’ll only get the resources to put out fires if they also start filling potholes. Yet being unable to put out fires is where GPs find themselves now.

We can also spot the same old mistakes around increasing GP numbers, with a handful of small initiatives ministers believe are sufficient to attract thousands more doctors to enter and stay in English general practice.

The Conservatives’ plans to increase GP numbers by 6,000 by 2024 include: reducing bureaucracy for those wishing to practise in the NHS (welcome but unlikely to have much effect); using technology to reduce workload – a slightly fanciful aim; and promoting networks to make general practice more attractive. These hardly foster confidence.

The NHS People Plan, on workforce, and GP access review are due soon and may well have sensible proposals. But again, these are unlikely to increase GP numbers by the necessary amount.

And even if general practice was rescued by well-targeted, radical proposals, I fear the NHS would remain at best stable. Because the rot is widespread. As our cover feature notes, many young people’s mental health services accept referrals only for the most serious cases. Thresholds for treatment are increasing in many other areas of care, public health cuts hamper genuine efforts at prevention, and the future of social care looks bleak.

However, I don’t want to start the year on a sour note. So here is my prediction for 2030: the NHS will be in such a state that politicians and the public alike will grasp the need to manage expectations. We’ll ditch DNA testing, seven-day routine services and pointless checks, and realise our health service can be great if it is allowed to treat sick people. However, that might be a fanciful notion too. Happy new year!

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