Intended for healthcare professionals


Labour would divert £100m from NHS reorganisation into primary care

BMJ 2014; 348 doi: (Published 13 May 2014) Cite this as: BMJ 2014;348:g3300
  1. Zosia Kmietowicz
  1. 1BMJ

A Labour government would ensure that all patients could get an appointment at their GP surgery within 48 hours and see their doctor on the same day if necessary, the party leader, Ed Miliband, has said.

In a speech in Manchester on 12 May, Miliband put the NHS at the heart of the Labour Party’s campaign to win power in next year’s general election.

He promised to invest an extra £100m (€122m; $169m) a year in primary care by scrapping competition rules in the NHS and cutting bureaucracy created by the coalition government. He said that this money could fund three million more GP appointments every year and take pressure off hospital emergency departments.

Miliband spelt out three ways that Labour planned to improve the NHS: ensuring that physical health, mental health, and social care services work together; making the NHS preventive, not just reactive; and replacing the principles of competition and privatisations with cooperation and integration.

As well as guaranteed prompt GP appointments, Miliband said that under Labour patients would have the right to book ahead with the GP of their choice. “This will be better for patients, because they have better access to their GP surgery; better for the NHS, because it will save money currently spent in [accident and emergency departments]; and better for Britain, because it is the kind of health service we need,” he said.

Labour said studies had shown that a 5% increase in patients seeing their preferred GP could reduce emergency admissions by as many as 159 000 a year and could save the NHS £375m.

Miliband also promised to repeal the “terrible” Health and Social Care Bill that the coalition government had passed in “a top-down reorganisation [of the NHS] that nobody wanted and nobody voted for.”

Labour said that the bill, which came into effect in April last year, had led to at least £78m being spent on unnecessary administration and legal fees and that the party would redirect this money to primary care.

Further money for GP services would come from scaling back three quangos—Monitor, the Trust Development Authority, and commissioning support units—which spend more than £3m a month on consultants.

“Why should a hospital have to spend money on competition lawyers instead of patient care?” asked Miliband. “We will stop that happening. We’ll stop the regulators from spending their time on free market competition in the NHS. We’ll cut back on consultancy costs caused by the Tories’ reorganisation. We’ll reduce the number of very senior managers who cost too much at a time when resources are so scarce.”

Maureen Baker, chairwoman of the Royal College of General Practitioners, welcomed Miliband’s promise to channel more money into general practice.

“We are pleased that politicians are starting to sit up and take notice following six months of campaigning by the college to bring attention to the fact that general practice is now teetering on the brink of collapse,” she said.

However, she warned that Miliband’s announcement “must not be another ‘sticking plaster’ solution but part of a broader, long term, shift in investment. Ultimately, general practice needs 11% of the NHS budget by 2017 in order to cut waiting times and guarantee safe care for our patients.”

Nigel Edwards, chief executive of the health policy think tank the Nuffield Trust, said that Labour’s plans for reorganising access to GPs “made sense.”

But he added, “Solving the problems of general practice is not just about getting people through the door. We need fundamental change to primary care that enables GPs and their teams to assume 24/7 responsibility for coordinating people’s care, supported by a network of other professionals like pharmacists, hospital specialists, and social workers.”

He said that such change required politicians to allow “local innovation within a clear set of aims for general practice.”

Amanda Doyle, chief clinical officer at the NHS Blackpool clinical commissioning group, said, “In principle we would welcome extra investment into the out-of-hospital offer, in which general practice plays a critical role. However, it is not the only part, and to truly transform care for patients an integrated approach across the whole health and social care system needs to be taken, with general practice alongside community services, primary care, and the wider health economy.”


Cite this as: BMJ 2014;348:g3300

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