GP care in England 'faces funds catastrophe amid cuts'


Dr Clare Gerada: "The front door of the NHS is the GP surgery, if that gives, the rest of the NHS will give very rapidly"

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The GP system in England is facing a "catastrophe" because of cuts in funding, doctors' leaders are warning.

Analysis by the Royal College of GPs suggests that over the past three years, investment in general practice has fallen by £400m in real terms.

That is equivalent to a 7% cut in spending per patient, it says.

Health Secretary Jeremy Hunt told the RCGP, which is meeting in Harrogate, he government wanted to increase access to GPs by extending opening hours.

On Tuesday, the prime minister said he wanted more patients to be able to get help in the evenings and at weekends, as he set out details of a £50m pilot programme in nine areas of England to widen access.

But the college said its analysis - based on official data from the Health and Social Care Information Centre - showed the government was taking money away from GPs despite claiming it wanted to move care away from hospitals.

The RCGP's chairwoman Dr Clare Gerada said the cuts meant doctors were being required to do more work with fewer resources, damaging services for patients.

'Increasing workloads'

In 2012-13, £8.5bn was invested in general practice, when everything from spending on pay, IT, tests and drugs was taken into account, it said.

Are patients being hit?

In many ways it is hard to measure what effect the cuts cited by the RCGP might be having.

The most obvious measure of judging performance used to be through the 48-hour target for waiting for an appointment. But this was scrapped by the coalition.

The Patients Association has consistently said the feedback it gets flags longer waits as an issue.

The RCGP also says it is getting harder to keep extra services going; such as dieticians and talking therapies.

Some of the biggest cuts have been among these 'enhanced services' - and in longer opening hours, the very thing ministers were talking about extending earlier this week.

For a government that makes a big play of protecting the NHS budget, it raises some tricky questions.

That compared with £8.3bn in 2009-10, which is the equivalent of £8.9bn in 2012-13 prices.

In terms of spending per patient, that represents a fall from £168.40 a year to £156.45 - a drop of 7%.

Dr Gerada also pointed out that the investment represented 9% of the entire NHS budget, even though GPs had 90% of the contacts with patients.

She said: "Our figures should send out a warning to government and the rest of the NHS that we will soon have a catastrophe on our hands if urgent action is not taken to reverse the decline in funding.

"GPs are keen to do more for their patients, but we are heaving under the pressure of ever-increasing workloads and diminishing resources.

"Some of us are routinely working 11-hour days with up to 60 patient contacts in a single day and this is not safe or sustainable.

"You do not want a tired GP seeing you. You do not want a tired GP any more than you want a tired pilot or a tired surgeon."

'Tipping point'

Dr Gerada also expressed concern about the season ahead and said general practice was close to reaching a "tipping point" which would see the profession "fall over".

"We're trying to squeeze more and more activity out of a smaller and smaller pot of money," she added.

"If we have a cold winter, I'm really afraid that patients will suffer considerably.

Start Quote

We're very frightened that there is a tsunami of work coming out, without the resources”

End Quote Dr John Crompton GP

"The front door of the NHS is the GP's surgery. If that gives, the rest of the NHS will give and very rapidly."

Health Secretary Jeremy Hunt, who addressed the conference on Thursday afternoon, did not object to the figures.

But he said the problems with investment in GPs "goes back further than three years".

"In the NHS we have invested in hospitals, in A&Es and we have not had a parallel investment in primary care."

He added the government was now looking to invest in programmes that increased access to GPs - hence the announcement this week to extend opening hours and increase the use of technologies such as email and Skype.

Patients Association chief executive Katherine Murphy said: "This chimes with what patients are saying to us. They are finding it harder to access GPs both in and out of hours.

"The mantra is about moving care out of hospitals and into the community, but if we are going to achieve that we have to stop throwing money at hospitals and invest in GPs so they can provide quality care."

Shadow health secretary Andy Burnham said: "These figures are embarrassing for a prime minister who got elected on a promise not to cut the NHS.

"They make a mockery of yet more promises he has made on GP access this week and show he simply can't be trusted on the NHS."


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  • rate this

    Comment number 68.

    1. flipmode wrote: And still the Tories want to go ahead and spend billions on a high speed train we don't need.


    You mean that YOU don't need

    Millions of us DO need it, however.

    Please don't assume that you speak for everyone in this country.

  • rate this

    Comment number 67.

    Yesterday this country was the "Land of opportunity", today we are facing a medical "catastrophe".
    Will anyone stop this maniac from selling off the whole country to the highest bidder?

  • rate this

    Comment number 66.

    For a change most comments seem to recognise that GP's have had their cake and eaten it and now want more cake. These same busy GP's seem to find time to set up their own businesses and make more money as an aside to their primary function. Ask a doctor who has trained as a hospital consultant about GP work and they know it is the easy option with structured hours of working and well paid at that.

  • rate this

    Comment number 65.

    Doctors are rapidly loosing public respect. They are headed in the same direction as teachers and the police, forever complaining about the need for change, increasingly poorer services and lack of empathy with the people who pay their wages.

  • rate this

    Comment number 64.

    Can anybody tell me (I have a little mean spirit inside me which suggests a reason) why we don't train more doctors? Surely if they're unbearably expensive and in short supply, we should make a few more?

  • rate this

    Comment number 63.

    My wife had a kidney transplant 13 years ago. She needs drugs to keep the kidney functioning, and management of her drug regime, side effects etc.She picked up an infection on holiday recently, and the Ukrainian doctor who treated her was excellent.
    Back in the UK, her treatment has been a mix of complacent and incompetent. I grew up with the notion that the NHS was the bee's knees. Not any more.

  • rate this

    Comment number 62.

    If any commercial business treated it's customers the way GPs do, they would be out of business in a flash. No wonder the GP service is struggling, the last labour government gave them huge pay rises and let them pick their own hours. This is just another scaremongering move by the GPs union to see if they can squeeze more dosh out of hard working taxpayers. The government needs to say no more.

  • rate this

    Comment number 61.

    Mm cant see the crisis in A & E being resolved anytime soon then.

  • rate this

    Comment number 60.

    Why import Drs- I think the answer is still that not enough are being trained in this country not that there are no candidates wanting to train. It was/is a cost saving strategy saving on the cost of training by using foreign practitioners trained at someone else's expense(often trained here) instead of them being encouraged to work in their own countries desperate for trained DRs.

  • rate this

    Comment number 59.


    Have you been to see a GP recently?

    It used to be the case that your GP would sit and take an interest in you. Now they either dish out antibiotics like sweets or refer you to more qualified doctors who specialise in the parts of you that are clearly problematic. They give the impression that any idiot with access to the internet could do the job. They want more for doing less.

  • rate this

    Comment number 58.

    GP's have got stressful decisions to make all week such as:
    Do i give the patients pills or... send them to a specialist
    or... administer pills for a month, then send them to a specialist
    And, they're only on £120K --- BLESS!

  • rate this

    Comment number 57.

    ..., and most of them work long hours with the pressure of making decisions that are potentially life or death.
    My foot do they. They're down the golf course a lot of afternoons and anything serious they refer to specialists.

  • rate this

    Comment number 56.

    You are correct Stefanovich in one sense - GP's class themselves as part of the NHS when it suits them to be employees (for pensions) but take self employed status when it suits them to do so (for tax reasons for example). They are self employed business people and should not be given a pension by the NHS - they earn enough to provide for their own pensions given their 6 figure salaries

  • rate this

    Comment number 55.

    this government wants to destroy the nhs,,is that not obvious to everyone by now

  • rate this

    Comment number 54.

    I do most of my diagnosis via Google.

    I don't have to wait 13 weeks, and it tends to be more accurate.

  • rate this

    Comment number 53.

    Let's assume for the moment that we have enough GPs ialready. To provide a first pass at a more efficient GP service, they and their practice staff should spread their existing hours over 7 days of the week rather than 5. Nobody works more hours, everybody works some "unsocial" hours (like much of the working population) and we can get to see our GP when we need to, not when we're told to.

  • rate this

    Comment number 52.

    Can anyone seriously be surprised,

    This is what happens when government try to make a business out of healthcare, just as with all the other privatisations it will end in higher costs and lower standards.

    If you think its bad now, “you ain’t seen nothing yet”

  • rate this

    Comment number 51.

    Which bit of 'austerity measures' which we have been asked to accept without comment or criticism, to fund the banks illegality, did they suppose would not affect them?

  • rate this

    Comment number 50.

    But I was under the impression that GP's now are not part of the NHS and have all set themselves up as contractors, hence no doctor in the evenings or weekends and endless calls to call centers who will recommend you go to the overcrowded and overworked A&E

  • rate this

    Comment number 49.

    If GP's can't increase their productivity by 2% each year they should be out of business.

    Everybody else has to.


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