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The budget ignores the crisis in general practice

Chancellor Philip Hammond’s has just announced a paltry financial support for social care in his spring Budget. He has joined other Tory ranks in boasts about funding, social care, and being ‘the party of the NHS’. I would say that either he underestimates the task before his Government or he is completely out of touch, because this Budget does precious little to address health and social care crisis.

This Budget once again has ignored the needs of general practice 

Let’s look at the facts. The £2bn for social care over the next three years is less than half of what has already been cut from social care. The NHS is already compensating the lack of social care funding through its own budget and staff. And, as we know, NHS funding is in dire straits. A BMA investigation into the 44 Sustainability and Transformation Plans (STPs) in England has revealed that £9.5bn is needed just to create the infrastructure to deliver the projects, with costly building projects and investment in community facilities vital to the STPs.

As for the chancellor’s commitment to put more GPs into A&E, he seems to be on another planet. We are already facing a severe recruitment and retention crisis in general practice. Having GPs in A&E won’t reduce admissions, if anything this will draw GPs away from the community and could have the effect of attracting more patients to A&E and worsen the GP crisis.

The chair of BMA Council, Dr Mark Porter, has stated the stark reality of the crisis: ‘This budget does nothing to address the gaping hole in NHS finances. There is a £30bn gap to fill and we should be increasing the UK’s health spending by at least £10.3bn to match that of other leading European economies’. The health and social care system is a mess. Net expenditure on social care has dropped in real terms from £8.1bn in 2005-06 to £6.3bn in 2014-15, a drop of more than 20%.

General practice remains on life support. The recent increase in GP contractual funding will be completely neutralised by national insurance rises. The answer to the funding crisis would be a firm commitment to get funding levels back to the EU average on health spending. The Prime Minister might say it depends on a strong economy, but I would say it depends on your commitment to the NHS. Besides, a healthy workforce makes better economics anyway. The NHS is not a plc, it needs adequate funds which largely can only come from the Government through taxation.

This Budget once again has ignored the needs of general practice and is further pushing it into a permanent decline. Rather than political gimmicks, what we need is more GPs, more practice staff, including nurses, and a programme of investment in GP practice buildings to bring them up to scratch. What must be made very clear to the chancellor and the health secretary is that the NHS in general, and primary care in particular, can no longer plug the gaps in social care. The social care budgetary increase is a pitiful sticking-plaster and an insult to our communities and a workforce that is already overstretched. 

Dr Kailash Chand OBE is a retired GP and former deputy chair of BMA council. You can follow him on Twitter @kailashchandobe