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News Election Watch

Tories promise 6000 extra GPs by 2024

BMJ 2019; 367 doi: (Published 12 November 2019) Cite this as: BMJ 2019;367:l6463
  1. Gareth Iacobucci
  1. The BMJ

General practice hit the headlines this week when the Conservatives promised to deliver 6000 more GPs by 2024-25 as part of a pledge to provide 50 million more appointments in GP surgeries every year.1

The announcement was immediately dismissed as “empty promises” in some quarters,2 given that the government has failed to achieve a very similar pledge made in 2015 for 5000 extra GPs by 2020. The number of GPs has actually fallen,3 and workforce and workload pressures mean that the new target looks highly unachievable.

Labour’s Jonathan Ashworth was quick to pounce, arguing that the Conservatives “always make election promises which they fail to deliver on.” Labour has pledged to increase GP training places in England by around 43%—from 3500 to 5000 places—if elected.4

But the health and social care secretary for England, Matt Hancock, said that his party would deliver. “We will put record funding into our GP surgeries to help everyone get the care they need,” he said.

The Conservatives insist that they have done their sums. They are promising an extra 500 GP trainees a year from 2021-22, bringing the total number of trainees up to 4000 a year. Trainees will also do a greater proportion of their training in general practice. The end result of this expansion will be 3000 extra doctors working and training in general practice by 2024-25, the party projects. It also promises an extra 3000 fully qualified GPs working in the NHS through better retention of domestic staff and improved international recruitment. The party said that it would work with the NHS on initiatives to improve retention and international recruitment but did not give further details.

In a related pledge, the prime minister, Boris Johnson, announced that, if re-elected, the Conservatives would create a new dedicated “NHS visa” exclusively for skilled staff from overseas who apply to work in the NHS. This will prioritise and fast track entry of medical professionals from abroad and halve their cost of applying for a visa, he said.

More GP appointments is always a vote winner, but even with the extra £2.5bn being made available over four years to fund the expansion in GP numbers, the Conservatives’ promise looks a tough ask.

Hancock also promised an additional £300m a year for 6000 more nurses, physiotherapists, and pharmacists in general practice by 2024-25. This would be in addition to the 22 000 support staff promised in the new GP contract earlier this year.5

Experts and medical leaders said that any funding and staffing increases were welcome but called for promises to be credible.

“We need to be realistic: training new GPs takes time; services are already under immense strain and face rising demand,” warned Tim Gardner, senior policy fellow at the Health Foundation.

Helen Buckingham of the health think tank the Nuffield Trust said, “We should remember the NHS has a long tradition of missing targets to train more staff. For every four GPs trained, only three make it through to the front line, and on average they work only two thirds of full time.”

Helen Stokes-Lampard, chair of the Royal College of General Practitioners, said, “Crucially, patients cannot expect this to happen overnight, as more appointments will only happen when other promises are delivered first.”6

The royal college and the BMA launched their own election manifestos last week with wish lists for a future government.78

And in Scotland the first minister and Scottish National Party leader, Nicola Sturgeon, announced plans to launch a bill at Westminster that would block any UK government from using the NHS as a “bargaining chip” in any future trade talks after Brexit.9

Away from the campaign trail, NHS England’s chief executive, Simon Stevens, wrote to NHS staff reminding them to avoid “public controversy” during the pre-election purdah.10 Such advice is common for civil servants and public sector managers in election periods, but senior doctors might wonder how it squares with their duty to speak out.