It’s time for Government to help out our beleaguered GPs
The heat continues to rise in the ongoing contract dispute between the British Medical Association (BMA) and NHS England.
You can read the BMA’s take on the dispute here, in a clip which also contains an explainer video.
While junior doctors have accepted the Government’s latest pay offer, the BMA is continuing to ramp up the rhetoric on collective action, accusing some NHS England officials of wanting to deliberately starve General Practice.
BMA GP Committee England chairwoman Katie Bramall-Stainer has said she feels the window of opportunity for NHS England and the Government to sit down with her to avoid a further escalation is rapidly closing.
GPs are ready for the fight
My own observation is simple – the Government and NHS England simply cannot afford to pick a fight with General Practice.
It’s not a good position to be in because there is no doubt that we’ve seen a real disparity between investment in General Practice and investment into hospitals, for example.
Lord Darzi’s just-released report into the state of the NHS concluded a decade of austerity has left the NHS in “critical condition” with poor cancer survival rates, and staff “disengaged” and prone to high levels of sickness absence. Anyone who has read this will understand the severity of the situation.
Whatever the solutions are, General Practice has to be an intrinsic part of them.
The Integrated Care Systems, on behalf of NHS England, were recently asked to give an estimate of how much unfunded work – one of 10 topics in the collective action for General Practice – exists right now.
The estimate was around 400,000 outpatient referrals a quarter and about £1.7billion of unfunded work is currently being managed by General Practice.
Another topic in the collective action is the encouragement of GPs to cap the number of patient appointments at 25 per day per clinician. That’s compared to the current average, which is said to be 37.
Withdrawing labour only deepens tensions
They’re looking to push the work elsewhere and all that does is heighten the tension between the BMA and NHS England.
I think Katie Bramall-Stainer is doing an excellent job, she’s been a real breath of fresh air in her role. I understand her view and I am generally very supportive of it in terms of General Practice. I’m amazed NHS England and Secretary of State for Health and Social Care Wes Streeting haven’t sat down with her and tried to do something about the problems.
In my work with two different NHS General Practice customers, the message I’m getting is that, right now, they’re playing down the discussions between the practices. They want each practice individually to decide which of the areas of collective action they want to implement.
That’s because they don’t want people locally to know what General Practice is doing, so that it makes it more difficult for Integrated Care Systems and other providers to then make any adjustments to cope with it.
A five-year deal is the best way forward for everyone – including pharma
This all boils down to the fact we must get this settled. At the beginning of September, the BMA published a safe working handbook, essentially a guide for practices to step up and take collective action and the things they might do.
Safe working limits must take into account the limited GP capacity. The BMA’s handbook is designed to help the practices make the decisions that are right for them and allow them to prioritise the very limited capacity that they have.
As battle lines continue to be drawn, I think this will be a topic that we will be discussing for quite some time to come.
I’m an optimist, and I hope the Government spots the opportunity to do a five-year deal that starts to remedy the underfunding and real neglect we’ve had of General Practice, creating a gilt-edged opportunity for pharma, med tech and device companies to get involved.
That should be a guaranteed deal for General Practice for the lifetime of the current parliament – index linked so it won’t matter where inflation goes.
General Practice has had 14 years of stagnation and lost funding. It is high time the balance was redressed.
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