OPENING the BMA GPs Conference in York, Doctor Nagpaul correctly pointed out that ‘Today, nearly a million patients will visit their GP surgery, that’s 16 times more than those who’ll attend Accident and Emergency units. UK general practice is truly the lifeblood of the NHS, its foundation and that which keeps the rest of the NHS afloat.’
He continued to outline the state of the profession. ‘Last year’s GP worklife survey by Manchester University showed GPs suffering extreme levels of stress – the highest since records began, and a sharp rise in those intending to retire early. . . And what’s NHS England’s cure? To shamefully threaten withdrawing occupational health services for over-stressed GPs and their staff when they need them most.’
He continued: ‘And if, as some politicians and others claim, general practice really is such a jolly for overpaid GPs, then why but why are young doctors shunning it in favour of working in hospitals? We can’t recruit enough GP trainees to even match the government’s own target to sustain general practice, with the numbers of young doctors choosing to become GPs going down 15% last year.
These doctors are not shunning the discipline of general practice, but the intolerable pressures that GPs are subject to, together with relentless attacks that devalue what we do, and which has butchered the joy and ability of GPs to properly care our patients.’
Indicting the government he added: ‘Let me warn those that continue in their quest to denigrate us. Continue to put off younger doctors into becoming GPs, continue to accelerate those leaving the profession, and you certainly won’t have the last laugh when you won’t have a GP to turn to in times of need, and when the NHS collapses because its very building blocks have imploded.
‘But we won’t just roll over and let this happen. General practice matters too much to you and me, but more importantly to our patients who fundamentally depend on us.’
Nagpaul continued: ‘And amidst all the vilifying headlines and distorted anecdotes, I’d like to thank our greatest partners and allies – our patients, the overwhelming majority of whom continue in repeated surveys to express gratifying levels of satisfaction and most importantly trust in their GP – something that will always elude politicians and the commercial world that government is so in thrall of.’
He outlined the profession’s priorities: ‘The immediate priority must be to protect those practices whose futures are at stake by imposed MPIG and PMS funding cuts. . .
‘We must then stem the relentless, unresourced work shifted into GP consulting rooms that overloads our ability to care.
‘It’s indefensible to have a funding system that pays for every contact and procedure in other parts of the NHS, while taking advantage of the capitated GP contract by piling open-ended work onto practices to simply absorb without any new resources or capacity. . .
‘We then need time to care. The ten minute consultation as a standard is an anachronism that should be consigned to the dustbin of history. Ten minutes is an insensitive insult to the needs of so many of our patients – those with long term, complex or mental health problems. GPs are forced into providing conveyor belt medicine at breakneck speed up to 60 times in a day.
‘We also need the physical space to care. With no national dedicated funding for GP premises in over a decade, we’re trying to provide 21st-century general practice from buildings belonging to a past era.
‘Politicians must also open their eyes to see that the crisis in the NHS isn’t only about four hour casualty waits, but also where 90% of patient contacts occur daily – in general practice. So while £500 million was given to ease the pressures in accident and emergency, it’s a kick in the teeth for general practice to receive £50 million not to ease any crisis or pressure, but actually to provide even more over seven days. . .
‘So, in conclusion, I’m asking government to decide whether it wants a sustainable future NHS. And if so, the question is not whether it can afford to support, invest in and develop general practice? The real question is can it afford not to?’
In his conclusion the GP chair did not deal with the real situation. The government has already decided to wreck, privatise and destabilise the NHS. It is looking to make the GPs the scapegoat of the exercise!
What is required is a real defence of the NHS. This means that the BMA and GPs must organise their greatest allies, their patients, alongside all the trade unions in a general strike to bring down this NHS-wrecking government and bring in a workers government.
