Public wants GPs to get greater share of NHS funding, finds leading think tank

There is ‘clear public appetite’ for shifting NHS funding towards general practice and away from hospitals, a health think tank has advised the next Government. 

Based on polling and workshops with the public, the Health Foundation has recommended policymakers ‘give primary care and community services an increasing share of the available resources’. 

Polling found that 60% of the public in England want the Government to prioritise access to community-based services such as their GP, within the limits of the current NHS budget. 

This compares to 29% of those surveyed who want hospital care to be prioritised. 

During the ‘deliberative workshops’, which sought to gather views on ‘challenging’ issues that do not have a simple answer, the Health Foundation found that there was ‘broad consensus’ for shifting funding towards primary care services. 

This consensus was based on the belief that general practice and community care can support earlier diagnosis and condition management, which can ultimately reduce the need for hospital care. 

However, participants in the workshops said they would not accept a ‘decline’ in the quality of hospital care as a result – instead, they wanted to see a ‘readjustment’ of resources over time.

The think tank noted that some participants ‘felt uncomfortable with increasing funding for primary care as they believed that GPs were overpaid’, but this view was not ‘widespread’.

This research also found that around half of the public (47%) would prefer to see an increase in taxes to maintain the current levels of care in the NHS, with those intending to vote Labour and Liberal Democrat more in favour than those voting Conservative. 

And public faith in the NHS’s founding principles remains ‘as strong as ever’, according to the think tank, with 88% of those surveyed agreeing that it should be free at the point of delivery.  

However, the research highlighted a ‘significant mistrust and lack of confidence’ in the current Government’s handling of NHS policy, with only 9% of those surveyed saying the Government has the right policies.

Based on this new evidence of public perceptions, and ahead of a general election, the Health Foundation advised the next Government to change the approach to NHS funding.

On primary care funding, it said: ‘Despite the high-profile pressures on the hospital sector, we found a clear public appetite for government to focus on improving primary and community care.’

‘While participants wanted people to be able to access hospital services when essential, they also recognised the need for the NHS to work as a system and that the population’s changing health needs would not be met by continuing to focus resources on hospitals,’ the report added. 

Tim Gardner, assistant director of policy at the Health Foundation, said it is ‘vital’ ahead of the general election for political parties to have a ‘deep understanding’ of what the public wants from the NHS.

He added: ‘The public clearly supports the need for greater investment in primary and community care to help our growing, ageing population to live healthier lives, as well as to help people manage illness better and ease the burden on stretched NHS hospitals. 

‘With such low confidence in the government’s handling of the NHS, the next administration must swiftly restore public confidence and be transparent about the challenges it faces.’

RCGP chair Professor Kamila Hawthorne said the Health Foundation’s research is ‘highly welcome’ and ‘chimes very clearly’ with the college’s own polling.

She said: ‘It makes absolute sense to better fund general practice and wider primary care given that GPs and our teams make the vast majority of NHS patient contacts, in turn alleviating pressures elsewhere in the health service.

‘Delivering care in general practice is also more cost efficient with the estimated cost of an average GP appointment approximately one tenth the cost of treating a patient at a major Emergency Department.’

The BMA GP Committee in England also welcomed the Health Foundation’s research, highlighting that ‘GPs are on the side of patients’.

GPCE chair Dr Katie Bramall-Stainer said: ‘We want to give – and patients want to receive – relationship-based care, from cradle to grave from a trusted family doctor.

‘The past decade meanwhile has seen us lose more than 1,000 practices and today we have almost 2,000 fewer full-time equivalent GPs than we did in 2015. Despite this, we are seeing more and more unemployed GPs as practices’ core bread and butter funding has been squeezed to the bone – £659 million eroded since 2018/19.’

She said the Government ‘refuses to act’ to fix these problems, which has ‘forced’ the GPCE to ballot GPs on collective action.

‘This is not an issue that will go away, for this Government or the next – with the public now clearly refusing to have the wool pulled over their eyes,’ Dr Bramall-Stainer added.

The Health Foundation’s findings were based on polling by Ipsos of 1,774 people living in England, and the deliberative workshops which were held over two days in three locations in England, with 72 people attending.

The King’s Fund, another leading think tank, has also called for the Government to ‘radically’ refocus the NHS on primary care, saying the lack of investment is ‘one of the most significant policy failures of the past 30 years’. 

While the Labour party has not committed to increasing GP funding if it formed the new Government, shadow health secretary Wes Streeting has indicated he may give general practice a larger share of NHS funding ‘over time’. 

He has also claimed that he has ‘made it very clear’ to hospitals that any funding that becomes ‘available’ under a Labour Government would go to primary care and other non-acute sectors.