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 180.

    Without reading every posting I wonder whether people are aware of the real statistics. 9% of the budget is spent on GPs who see 90% of the number of patients. Makes you think. We cannot expect doctors to work longer hours than they do already so we need more doctors. We cannot expect doctors to spend more than the eight average minutes as there aren't enough doctors so we need more doctors

  • rate this

    Comment number 99.

    With GPs now in charge of the NHS budget, perhaps they'll spend more on solving people's medical issues within primary care & not sending people off to expensive hospitals at the 1st opportunity.

    If as a result they gave themselves longer with each patient in the first place, they might find that many patient issues are solved without the need for a further appointment with the GP or hospital.

  • rate this

    Comment number 91.

    I have three GP's in my extended family and all complain of time wasting patients who deny the genuinely ill resources & attention. They also say this is not a minor problem and some surgeries suffer 20-35% 'patients' who just need to take an aspirin, visit a chemist and - all too frequently - stop malingering. Hospital A&E's suffer the same problem. People who misuse the NHS are common thieves.

  • 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 47.

    So the GP's who cost the NHS millions more under the last government now warn that service is under threat if we try to control the spending.

    In other words, they are saying they will make the public suffer rather than the reality check effecting their huge salaries and pensions.


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