NHS reforms: GPs losing faith, BBC poll suggests

Stethoscope GPs are taking charge of the majority of the NHS budget under the reforms

The number of GPs who believe that the government's health reforms in England will improve patient care is falling, a BBC poll suggests.

Just 12% agreed that putting GP-led groups in charge of the budget would mean patients saw a "noticeable" improvement.

That figure was 23% when a similar poll was carried out in September 2010.

A majority of the 814 GPs polled also believed there would be more rationing of care because of financial pressures.

In total, 83% said there would be an increase in rationing in their area.

Ministers have cited the financial challenges facing the health service as one of the reasons they have pushed ahead with the changes in the face of mounting opposition.

While 12% of family doctors agreed that GP-led commissioning - the buying and planning of services on a local level - would improve care, some 55% said they disagreed and 33% said they did not know whether or not it would.

The polling also asked about another controversial aspect of the reforms - the role of the private sector.


Asked about the role of private companies in the NHS, 87% agreed the changes set out in the health bill would lead to them having a bigger role.

The King's Fund, a health think tank, said the poll highlighted once again the challenge facing the government in carrying the NHS with it as it implemented the health reforms.

"GPs will be in the vanguard of this - their commitment is essential for implementing clinical commissioning, the government's big idea for ensuring that care meets the needs of patients," said chief executive Chris Ham.

"The public will judge the government's stewardship of the NHS on the basis of whether patient care improves, so ministers should be concerned that many GPs fear that care will get worse rather than better in the years ahead."

Dr Laurence Buckman, chairman of the British Medical Association's GPs committee, said the findings came as no surprise and reflected what doctors had been telling them directly.

"Increasingly, GPs are worrying that they will be blamed for making the hard decisions that may need to be made in order to meet the £20bn savings target set by the government. The government needs to be much more upfront with the public about the scale of savings that need to be made and why.

"If those who will have to deliver the latest health reforms are unconvinced and reluctant, the government should take notice of what they say."

April changes

In April next year the control of about £60bn of the NHS budget in England is due to pass to GP-led groups that will plan and buy most routine healthcare for their local community.


More than anyone else in the NHS, GPs are central to the government's plans for the NHS.

If you're a patient in England, your surgery will have agreed to work with others in your area. From April 2013, these GP-led groups - 240 of them - will be taking control of £60bn of the NHS budget.

So what GPs think matters, because they're essential to making this new system work.

This polling by ComRes suggests a deepening scepticism among GPs that putting them in charge will improve patient care.

Some believe they have been given too little power. Others are worried they're taking over as the NHS faces the lowest growth in its budget since the 1950s.

They will be taking over at a time of unprecedented financial pressure. The latest government statistics suggest the NHS is currently managing to meet all waiting targets and has found the savings needed in the last financial year. The polling for the BBC suggests considerable anxiety about what lies ahead.

Almost half of the GPs, 49%, thought the NHS would not be able to go on meeting the 18-week target for routine treatments. Just 22% thought that it would be possible. A similar picture emerged for A&E departments, with 42% agreeing the NHS would need to close or downgrade some in the next five years.

The health secretary Andrew Lansley said the Health and Social Care Act would hand power to GPs, put patients at the heart of the NHS, and reduce needless bureaucracy.

"Of course, every important reform to the NHS, under whatever government, has had its critics from within the system. But putting GPs in leadership positions in the NHS will mean they can improve services for their entire local population. Patients want doctors to make decisions about their care, not managers, and that is what our reforms will deliver."

Andy Burnham, Labour's shadow health secretary, said the findings were significant.

"Most GPs are clear that the NHS is going in the wrong direction and that the government's changes will make it worse not better. These results echo the concerns Labour has consistently raised and flatly contradict the reassurances given by the prime minister to get his Bill through."

The poll interviews were carried out by ComRes for the BBC between 21 and 30 March.


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  • rate this

    Comment number 84.

    74. John

    It depends what it (the NHS) is allowed to specialize in.The point is that the private sector picks the more profitable stuff; i.e out pts hence the NHS "core services" suffer as there is less funding available.

    Thats the problem!!

    Off now bye bye.

  • rate this

    Comment number 83.

    As I understand the system, this means medical decisions will not be entirely without financial concerns for the GP's?

    If this is the case, will it not create a situation where someone will not know if they are not being referred to Hospital because of financial, rather than medical reasons?

    And if THAT is the case, is there not a risk of A&E's being swamped with people who want to be sure?

  • rate this

    Comment number 82.

    Given that there around 34,000 GPs currently working in England (give or take a few), a sample size of 814 is in fact adequate to give a statistically significant result.

  • rate this

    Comment number 81.

    I thought these proposals were to stream line from the top down and reduce management costs,but from what I have seen that wont happen as the intention is to double the no of Quangos to oversee things,it goes from 164 bodies to 294 so how can that be more cost effective and thats before you get to the grass roots,ie the medical side of things.

  • rate this

    Comment number 80.

    There are big problems with the docs running this. They are being forced to take shortcuts because of meddling politicians who still never consult any people working there eg docs, nurses etc. this shift of money is because the politicians protected the managers of the NHS who caused this mess. Listen please. To expect a group of drs to take this suddenly is unrealistic. Get real Lansley.

  • rate this

    Comment number 79.

    74. John_Bull

    'NHS has already benefited from outsourcing specific functions.'

    The NHS may have benefitted financially from outsourcing cleaning, people in hospital dieing of infections have not. Getting the lowest bidder to provide services will always create a race to the lowest standards. As a tax payer I want the best service not the cheapest; privatisation has never improved a service

  • rate this

    Comment number 78.

    Private companies have no place in the NHS, Agencies supplying bank staff is the next big scandal waiting to happen. Somethings are best run by the State, some by private enterprise, Cameron & co need to recognize this and stop trying to res-erect Maggie's ''vision''.

  • rate this

    Comment number 77.

    71. John
    Yes to the NHS no to local GPs who work when they want to and earn as much as the private sector do.


    Almost all GP's ARE private sector and always have been! It shows how little the general public knows about the NHS. The GP's are self employed and run practices as private businesses to provide services for the NHS. The reforms are basically expanding what we already do!

  • rate this

    Comment number 76.

    Who are these GPs everyone speaks of? Are these what we used to call "doctors" before they brought in receptionists and triage nurses to keep the rabble at arms' length? It became so difficult to see one that I gave up on them a decade ago and feel fine. If the local casualty department t would go back to doing non-emergency "walk-ins" we could manage with a lot less of these moaning medics.

  • rate this

    Comment number 75.

    No surprises that the G.P's are unhappy about the NHS changes and I've just read that Andrew Lansley is advertising for a P.R. guru to do what he could not do and that is SELL the changes to we the public and the media. It would be funny if it weren't so desperately serious and we can only hope that the forthcoming May elections give the Con/Dems a really bloody nose.

  • rate this

    Comment number 74.

    "if the NHS was allowed to cherry pick the services it provides it too could provide a cheaper service"

    The NHS doesn't need to cherry pick, it will always be funded to carry out its basic function.
    But it always more cost efficient to specialise rather than trying to do everything, and NHS has already benefited from outsourcing specific functions.

    So, what is the problem?

  • rate this

    Comment number 73.

    I don`t suppose the GPs are losing support for the stupendous amount of money we citizens pay them for the much reduced service they now provide.
    To the pensioner looking for an out of hours visit, their objections seem fallacious!

  • rate this

    Comment number 72.

    I have just read through the lowest rated posts and some of the things said by the posters are truly frightening. I am glad to see that the majority of people have some commonsense and have given these types of post the rating they deserve.

  • rate this

    Comment number 71.

    I have total faith in doctors and nurses who work in hospitals, but local GPs who wont even come out after 8 at night and cherry pick what they want to do have little support from me. Yes to the NHS no to local GPs who work when they want to and earn as much as the private sector do. Its time we cut GPs pay and increase pay to those who work in A&E and our nurses.

  • rate this

    Comment number 70.

    @63 - a poll of 814 GPs is quite representative, given the polling size compared to the number of GPs. Political opinion polls (undertaken among the voting population of >40 million) usually have a thousand respondents, and are statistically significant. The GP sample against population is much larger in comparison. Your lack of knowledge of statistics does not invalidate the findings here.

  • rate this

    Comment number 69.

    Disproportionate measures undertaken without due care and attention and consultation with medical professionals demonstrate a neglectful indifference on the government's part. Our provision stands to suffer greatly from this:


    The NHS is one of our great achievements and it is fast being unravelled.

  • rate this

    Comment number 68.

    Get your facts right the GP's were consulted and at length,
    CCG's are up and running across the Country led by GP's. stop reading mickey mouse comics and read the stuff on the NHS sites or is that too difficult or will it mean that you have to read and understand what is really happening. Labour brought in far more privatisation than is currently planned read and inwardly digets

  • rate this

    Comment number 67.

    if they want to make cuts then cut GP pay and make them work shifts like most other industries have to in 24 hr type industries of which this is one.
    they opened a day surgery at solihull hospital and are now closing it as it is too popular (1st come 1st served). it's busy because you can't get appointments at local GP's for several days.

  • rate this

    Comment number 66.

    They have one aim, to destroy the NHS, they have always wanted to do it, the financial crisis merely gave them the excuse. They dont like any organisation to have power, that belongs only to the elite, this is Tory dogma.

  • rate this

    Comment number 65.

    46. John Bull.

    Because if the NHS was allowed to cherry pick the services it provides it too could provide a cheaper service.

    Where is the evidence that Bupa is more efficient?

    The summ of the whole is worth more than the cost of the individual parts in my view.


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