Successive governments are responsible for GP crisis

I was shocked by the findings of the House of Lords Committee on NHS sustainability.1 I looked at the members of the committee. It comprised two surgeons, a professor of medicine, an obstetrician, a former Minister of Health, former politicians, a former headmaster, and retired administrators, among others; there were no general practitioners. Yet they concluded that “the traditional small business model of general practice is no longer fit for purpose and is inhibiting change. NHS England with the help of the Department of Health and the profession should conduct a review to examine alternative modes and their contractual implications. The review should assess the merits of engaging more GPs through direct employment, which would reflect arrangement elsewhere in the NHS.”

I was a GP from 1980 to 2015. If, as I think, general practice is in crisis, then the fault needs to be put squarely at the door of successive governments and bureaucrats.

The partnership model of general practice did, and still does, serve patients well. If GP numbers had risen in the same way as hospital medic numbers, there would be no crisis. The Quality and Outcomes Framework and the Care Quality Commission have taken doctors’ time away from caring for patients. Abolishing these and redirecting their considerable funds into general practice would improve patient care.

My generation of GPs are retiring, but when we advertise for new partners, we get only one or two applications. When I started, partnership posts would attract 30-40 applications.

GPs need more support, not the constant kicking and tripping up, which is followed by complaints when outcomes aren’t perfect. Successive governments have wanted to control GPs. When we are employees, the service will be as good as the average emergency department—in other words, worse than the current, failing system and more expensive.