General practice will be transformed into a seven-day service as part of Jeremy Hunt’s promised NHS ‘revolution’ after the Conservative party secured a shock majority in the UK general election.
Health leaders broadly welcomed the reappointment of Jeremy Hunt as health secretary, with many arguing it will provide continuity.
But the GPC has appealed for the government to abandon key manifesto commitments and focus on tackling the crisis in general practice.
GPC chairman Dr Chaand Nagpaul called on Mr Hunt to scrap ‘unrealistic’ and ‘populist’ access plans. The Tory party has promised 8am to 8pm, seven-day access for every patient in England by 2020, and same-day appointments for over 75s.
Dr Nagpaul said the immediate crisis in workforce and workload meant the secretary of state should ‘jettison the populist pledges and deal with the harsh, bleak reality that we simply don’t have a general practice workforce that can meet current pressures’.
However, Dr Paul Charlson, vice chairman of the Tory party-affiliated Conservative Health group said expanding access was what patients wanted. ‘Whether GPs want it is another matter,’ he added. ‘We have to do what the taxpayers, our paymasters, want.’
King’s Fund senior research fellow Rachael Addicott said that while plans to expand access could be technically possible it was ‘questionable’ whether GPs could deliver them with current resources and capacity.
The Conservative party faced criticism from GP leaders during the general election campaign for failing to explain where the 5,000 new GPs it had pledged to ‘train and retain’ would come from.
We don’t know if 5,000 GPs will be the right number for the NHS.’
Rachael Addicott, King’s Fund senior researcher
Given the time and expense of training GPs, Ms Addicott said she understood doubts over whether the target could be met. She questioned whether 5,000 GPs would meet the needs of the NHS, given the lack of data to base this on. ‘At the moment we don’t know enough about what the right number is or how much it might cost,’ she warned.
Dr Charlson said it was ‘difficult to say’ whether the 5,000 target was achievable. It could be met through reducing the number of consultant places, and developing models of working to create more career options, he said.
Following his reappointment Mr Hunt said transforming out-of-hospital care was his top priority. ‘We need a step change in services offered through GP surgeries,’ he said. The statement echoed comments in an exclusive interview with GPonline before the election, in which Mr Hunt pledged that GPs would be at the heart of a revolution to transform primary care.
Tory support for GPs
Dr Charlson said a stable, majority government would be good for the NHS, and argued that the Conservatives support general practice.
Ms Addicott added that she was ‘encouraged’ that the government does not appear to want to work against the NHS’s own vision. ‘There has been a lot of instability and fragmentation over the past few years, so with Jeremy Hunt back in the post, it does provide some much needed continuity,’ she said. ‘Hopefully everybody can get on with trying to achieve the ambitions of the Five Year Forward View without concentrating on structural upheavals.’
Former RCGP chairwoman, professor Clare Gerada, however, slammed Tory plans. Same-day appointments for the elderly would increase inequalities by ignoring the effects of deprivations, she told GPonline. ‘Access isn’t the most important thing that equates to outcome; it’s continuity. We don’t need seven-day general practice’, she said.
The south London GP, who quit her position at NHS England London to speak out against the Conservatives ahead of the election, said she was ‘very anxious’ about the future of the health service under Tory majority rule.
The result could lead to more practice closures, marginalisation of GPs and privatisation of the NHS, she warned. Her comments were dismissed by a Conservative party source as ‘baseless scaremongering’.
The King’s Fund called on the government to use the forthcoming spending review to put the NHS on a sustainable financial footing. The £8bn-a-year funding rise pledged by the Tories to help plug a projected £30bn black hole was welcome, the thinktank said, ‘but is the bare minimum needed to maintain standards of care and will not pay for new initiatives such as seven-day working’. NHS England has committed itself to £22bn efficiencies over five years. The King’s Fund called for additional funding this year and a ‘renewed drive to improve productivity’.