The public is ‘not stupid’ and will not allow the Conservatives to ‘replace’ doctors with ‘half-qualified’ staff, a heckling GP told Rishi Sunak last week.
Locum GP Dr Jane Lees-Millais confronted the Prime Minister on the ‘constructive dismissal’ of general practice during an election rally on Friday.
She interrupted Mr Sunak during his visit to Swindon and Wiltshire on Friday shouting that ‘lesser qualified people’ are being used to conduct consultations which are ‘massively complex’, and that GPs ‘cannot be replaced’.
She told him that the NHS ‘is disintegrating’ and blamed GP unemployment on Government policies.
It comes after the BMA’s GP Committee England chair warned that general practice has suddenly gone from a recruitment to an employment crisis, driven by the Government’s squeeze of practice finances.
Pulse also revealed that locum GPs are having to drive across England and stay in hotels overnight in order to secure work and increased competition for salaried GP roles has left GPs struggling to find work.
As Mr Sunak was live on Sky News giving a campaign speech, Dr Lees-Millais said: ‘I’m one of 2,500 GPs in this country who are currently unemployed due to your policies. What are you going to do about that?
’37,000 GPs will not vote Conservative because of the constructive dismissal of general practice that is currently occurring.
‘You cannot employ lesser qualified people instead of GPs, they cannot be replaced. The country is not stupid.
‘Lesser qualified people are being used to conduct consultations which are massively complex – most people we see over the age of 40 have at least six different diseases going on at once. They cannot be coped with by half-qualified staff.’
When she was heckled by a man shouting ‘most GPs spend more time on holiday than in surgery, love’, Mr Sunak laughed.
He responded to Dr Lees-Millais saying that he knows ‘a thing or two about primary care’ and that the Government is ‘supporting GPs’ and ‘making it easier for people to see other primary care practitioners’.
He said: ‘My dad was a GP, but my mum was also a pharmacist – so that’s the household I grew up in. My parents dedicated themselves to primary care and I know a thing or two about it, I worked very hard in my mum’s pharmacy.
‘And whilst we are supporting GPs right now, supporting them with investment in digital telephony to make sure we can make it easier for people to get access to them, we are also making it easier for people to see other primary care practitioners to get the treatments they need.
‘And that’s where I respectfully disagree with you, because I do think it is right that now people can see their pharmacist to get their medicines for seven common ailments.’
BMA GP committee chair for England Dr Katie Bramall-Stainer said that a ‘constructive dismissal’ is exactly what general practice across England is witnessing.
She said: ‘GP services are being broken and over the past decade more than 1,000 practices have closed their doors for good.
‘We are not allowed to spend any of the funds provided by government to hire staff on GPs or new practice nurses. It’s no surprise that, as the lady mentioned, we are now seeing thousands of unemployed GPs. This is a national disgrace.’
Last month, the BMA warned that thousands of newly qualified GPs could be unemployed this August due to a ‘nearly non-existent’ job market in some areas.
GP practices have also been forced to make GPs redundant due to the changing financial situation.
In Surrey, a practice made three GPs redundant, citing ‘new ways of working’ including virtual appointments and the use of ARRS staff. Pulse later revealed that the GP partners had been unable to take any drawings in the previous year since the practice was ‘running at a loss’ and needed to save £350,000 per year.
Up to 80 members of staff at a Plymouth GP provider could soon lose their jobs following a redundancy process aimed at reducing the number of clinicians who work remotely.
And Pulse revealed in March that as many as 150 clinicians working for eMed, the new owner of GP at Hand, could be affected by a large-scale redundancy consultation, said to be affecting ‘mainly GPs’.
Last week the first part of Pulse series looking at the role of physician associates in general practice looked at whether they really are replacing GPs.
Labour’s shadow health secretary Wes Streeting said: ‘Rishi Sunak’s never had to struggle to get a GP appointment, but the state of the NHS under the Tories is no joke.
‘GPs are busting a gut to see more patients, but it’s not enough because the Conservatives cut 2,000 GPs.
‘Only Labour can deliver the change the NHS needs. We will train thousands more GPs and bring back the family doctor.’
but,, but, but …my father is a GP and I worked very hard in my mother’s pharmacy
Give that GP a standing ovation. I’m totally with you Dr, 200%. This rich financial man’s unscripted reply is fascinating “ I worked very hard in my mum’s pharmacy“ Did you Rishi? Has pharmacy first and scrapping GPs got something to do with your mum and dad? Gold dust. I can tell you its going to take something pretty remarkable for me to ever vote conservative again. What a totally detached bunch of weirdo morons these people are. These people so totally convinced they know how to run the country because of their exceptional personal first hand understanding of how the country works. Like that Lord who thinks his experience working at the Ministry of Sound as a kid makes him uniquely qualified to pass judgment on the use of PAs. The destruction of General Practice is a very personal thing for these people. They don’t like GPs. They want them gone. Well Mr Sunak ..truth is the rest of the country wants YOU gone. ON YOUR BIKE
I would have thought that if having GP and pharmacist parents was so inspiring that entering the health service for Mr Sunak himself may have been a more attractive option than the lure of money as an investment banker -nevertheless we can see with PCN CDs what the attraction of money / CD payments will encourage individuals to do even if plainly and obviously harmful to ones own colleagues and the health service users you should be serving !
Sunak, and most other politicos, along with NHSE repeatedly conflate General Practice with Primary Care. They don’t care whether patients see a PA, an ANP or a Pharmacist instead of a GP, as long as they can spout meaningless statistics to show many “additional” consultations have been provided since the inception of ARRS. In the event Labour do win the General Election nothing will change. CDs on the Boards of ICBs and on PCNs have no incentive to rock the boat and actually fight the corner of General Practice. There are too many with vested interests who seem happy to oversee the demise of General Practice.
The usual “i know all, you know nothing” and “I’m big, you’re small ….. bugger off” mindset.
The government’s policies are pushing out highly trained GPs and replacing them with less qualified staff, which is harmful to patient care. GPs have extensive training to handle complex cases that less qualified staff simply can’t manage. The lack of jobs for GPs, despite the high demand for their expertise, is a national disgrace. Patients deserve to be seen by properly trained doctors, and GPs should be supported, not replaced by inadequately trained personnel.
I would like to remind you there are only 1950 PAs in primary care. PAs are a valued additional resource to tackle the workforce crisis in the NHS – and don’t deserve to be the punching bag for this crisis in GP locum sessions and lack of employment opportunities for salried GPs.
The real Culprit is the lack of adequate funding to primary care over the last decade since the govenent started to siphon back the QOF payments given with the change in contracts in 2004. The DOH has imposed contract after contract on Primary care with less and less resources, until the real sting in the tail – PCNS – where even more QOF money was taken out and rebadged and returned via new targets to get old money back that yu can only use on ARRs staff, not GPs.
QOF payments were now essentially part of Core funding – as this had been used to hire more GPs and nurses and staff to deliver the chronic disease work diverted from hositals to GPs – with vast majority of chronic disease still in GPs with the funding now reduced/removed. This has left a huge black hole in budgets and no ability to pay for the GPs we still retained let alone hire new ones as outside ARRS criteria to hire GPs.
In fairness I know plenty of practices who could not find a partner or salaried doctor despite multiple adverts, as doctors wanted to locum. The market was upset with COVID, and now with ARRS, the landscape has turned on its head. However this is not down to PAs, but government policy and failure to fund Primary care adequately, the BMA for failing to negotiate a decent contract, and primary care for failing to strike or make a fuss as we were being mugged repeatedly and less paying for the NHS defecits in secondary care – as funding has shrunk
Current workforce plan commits to doubling the number of medical school places in England, from 7,500 now to 15,000 by 2031.
NHS England pledged to increase specialty training places by 50%, from 4,000 to 6,000 by 2031, with the first 500 new places available in September 2025.
More staff are coming and this is a good thing – we just need the funding to allow practices to be able to hire them, as well as having adequate estates/building space to house them.
Stop fighting the wrong battle – its a funding issue, we need more funding to allow us to expand GP numbers, ring fence it with a basic GP allowance to ensure it is spent on GP to keep a minimum number per head of population, but utilise the allied health professionals to improve the access problems and improve the patient journey for planned and chronic disease where possible, and aim to have a world class primary care again.
Some very helpful valid points on the main issue that was so aptly and bravely stated by Dr Lees-Millais on Live TV. Far more effective than our Leaders
I’d like to call out the comment “she was heckled by a man shouting ‘most GPs spend more time on holiday than in surgery, love’, Mr Sunak laughed.”
Calling a trained professional “love” is bad enough but the PM laughed
We have frankly lost the public and we need them onside . The endless media rhetoric and negative comments about GP’s. People do believe that we are on holiday or golf courses sadly. We need to win back the public
The BMA media campaign- did you even know there was one!
I am a GP. I have never worked so or an feltt more pressured. I want to see my patients as you do. Under funding and constructive dismissal of general practice, well said
Look forward to a group of patients heckling GPs in public.
Shouty harassment of people is not civilised behaviour.
With respect Dave Haddock this is a politician. He’s standing for election to be prime minister of the country. He was giving a campaign rally speech trying to persuade people to vote for him. The is not ‘shouty harassment’ its healthy necessary democratic debate. Your analogy is completely invalid
I don’t blame Gp’s for working as CD’s. They were sold PCN as working at scale, new money and services for PTS. Social navigators for PTS are great, as are ahp services like physios.
Pharmacy first could work for really simple things, but 1) chemists no longer need to be on site, so pharmacy asst aka HCA can’t see/ treat people with fp10
2)payment for easy stuff needs to be commensurate, not a premium on what a GP gets paid.
I’m an unemployed GP, I work part time in a community setting. 111 think ACP is answer to urgent care now. God help PTS, non conveyance by las is the hoped for outcome, patients best interest doesn’t come in to it., God help staff in A& E, no wonder they are flooded.
GP appointments are counted by number in stats, not by skill of staff seeing PT. Implication is quality or continuity of care don’t matter, which in statistics measured is true. Result, people who can pay for private care get quality medical/ GP care, those who
can’t get ‘ clinical’ care by ‘practitioner’ with no clear skill or role definition.
Third world healthcare is better than none, seems to be the wealthy conservative notion.
Well done to GP speaking out, letts have more of this.
There’s loads of money spent in NHS, implementing and then managing this down regulation of quality but carefully not measuring it.
Take money out of the bulging corporate structure of meaningless bean counting, put it into front line staffing. Define what all ahp can do, and not do, and manage medical, nursing and ahp, with people who can do the professional jobs, just like banking accountancy and law, and we get a functional service back, funded by productivity savings in the top heavy, incapable management.. More money means more management of front end staff providing the service.
We only need the service, not the meddling burgeoning management, who can’t / won’t sort issues, it, pension, payroll, serial murderers etc when they occur.