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There’s a hole in your manifesto, dear David, a hole



As I read the Conservative manifesto yesterday, I was reminded me of an old playground song about having a ‘hole in my bucket’.

You know the one, ‘There’s a hole in my bucket, dear Liza, dear Liza. There’s a hole in my bucket, dear Liza, a hole.’ Because a glaring aperture in the base of the new shiny pail being presented by the Tories was the promise of 5,000 new GPs.

In our recent Q&A with the Prime Minister, David Cameron said that ‘making sure we have the right number of well-trained, motivated staff is key to the future of care in this country’.

But despite this, he seems to have conveniently left a promise to boost GPs out of his blueprint on how he will run the country if he forms a Government from May.

He remembered to put in the (badly worded) promise that everyone will have access to ‘your GP’ seven-days a week.

The pledge that everyone will have a specific, named GP.

That all patients aged 75 and over will have the right to a same-day appointment if they need one (although who will decide ‘if they need one’ is not explained).

But on the matter of staffing these ambitious pledges? Some woolly words on continuing ‘to ensure that we have enough doctors … to meet patients’ needs’.

Continuing? That is a joke. We may have 1.7% more full-time equivalent GPs since 2013, but this is way below what is needed if you listen to the recruitment problems that practices are having at the moment.

Despite promises to boost the number of GPs in training, we have seen the worst recruitment round in seven years. And figures revealed by Pulse show this year could reach a new low.

BMA survey figures released today show the extent of the leaky bucket of GPs, with a looming retirement boom and one in five trainees saying they will simply get through training and then disappear on the nearest plane to practise abroad.

I could go on.

The fact is the Conservatives – and Labour, which promises 8,000 more GPs – know they will struggle to deliver an increase in GPs unless something fundamental is done to reduce the pressures on the service so that doctors in training see the profession as an attractive place to work.

Why would you become a GP if you see partners working 10-hour days and buried under piles of paperwork rather than treating patients?

Funding is key here, but let’s be honest the biggest problem is that morale in the profession has reached a nadir that it will be very hard to keep the existing numbers of GPs, let alone grow them.

Rebuilding faith in the profession means rethinking entirely the high-handed NHS approach to GPs, stopping the negative briefing against the profession and defining carefully what general practice is there to provide, and most crucially, what it isn’t.

But then I suspect, Mr Cameron, you know that already and that is why no numbers appear in your manifesto.

Then fix it, dear David, dear David, dear David. Oh fix it, dear David, dear David, stop talking and just fix it.

Nigel Praities is editor of Pulse