Former health secretaries take swipe at GP leaders during Covid inquiry

Two former health secretaries have taken a swipe at England’s GP leaders whilst questioned as part of the Covid inquiry in the past week.

Sir Sajid Javid accused the BMA’s GP Committee of not ‘putting patients first’ during a ‘national crisis’, while Matt Hancock claimed it was the GPC who put a ‘political spin’ on the pandemic row surrounding face-to-face appointments.

When asked about his handling of the Omicron wave, Sir Sajid pointed the inquiry to a £250m winter ‘access package’ for GPs in 2021 which was contingent on increasing the proportion of face-to-face appointments. 

At the time, the BMA criticised the package, saying it was ‘flawed and patient care will suffer as a result’. 

Sir Sajid, who was health secretary for just over a year from June 2021, told the Covid inquiry yesterday that this reaction was ‘disappointing’ and suggested that it did not reflect the views of individual GPs.

He said: ‘We put together a winter […] access package for GPs, and there were £250m of funding available for GPs and a whole programme of support, and I was very disappointed that when we took that to GPs – GPs generally as individuals really welcomed it in my interactions with GPs – but the BMA’s General Practitioner Committee was very much against it and didn’t recommend it.

‘And that was very disappointing because I felt that they weren’t putting the interests of patients first, which is what I would have expected in a time of national crisis.’

In response to these comments, the BMA told Pulse that ‘putting patients first was a top priority for GPs’ during the pandemic, and that it is ‘categorically untrue for any member of the former Government to suggest otherwise’.

The inquiry’s lawyers also questioned Sir Sajid on his comments in Parliament in September 2021 about GPs offering insufficient face-to-face appointments, which provoked an immediately negative response from the BMA. 

Lead counsel Jacqueline Carey KC told him: ‘You said that it was not intended to create a league table but it appears certainly that was how it was potentially reported in the press and that many members of RCGP felt demoralised by what they perceived as a constant media attack and a lack of support from the department and, indeed, from ministers.’

Sir Sajid said in response that by September 2021, there was ‘a reasonable expectation of the public that it shouldn’t be as hard as it was to get a [face-to-face] GP appointment, as it was in the previous year’.

He also claimed that it was ‘almost like some kind of postcode lottery’, where the likelihood of getting a face-to-face appointment depended on the location of a patient’s surgery. 

Both former health secretaries were questioned as part of the third stage of the inquiry, which is examining the impact of the Covid pandemic on UK healthcare systems.

Mr Hancock, who gave evidence on Thursday last week, was asked if he had been ‘involved in blaming, in any way, GPs for what is perceived to be a lack of face-to-face consultations’.

To this he denied blaming GPs, saying he is a ‘strong supporter of virtual consultations’ and claiming that the media’s narrative calling for more face-to-face appointments was ‘a load of rubbish’.

The inquiry then pointed Mr Hancock to a letter from former GPCE chair Dr Richard Vautrey in May 2021, which called for an urgent meeting with the health secretary as GPs ‘do not feel supported by the Government or NHS England’ regarding face-to-face appointments. 

Responding to this, the former health secretary said: ‘There were discussions in the media about the requirement to have more face-to-face GP appointments. I didn’t subscribe to that view, whatsoever, and in fact went out of my way to make the case for online consultations, and still do.’

‘I thought that the argument that GP appointments ought to be face-to-face and there’s a sort of values-based argument, I thought that was a load of rubbish,’ Mr Hancock added. 

Dr Vautrey’s letter came following a row in September 2020 over NHS England’s communications to GPs which ‘reminded’ them that patients must be offered face-to-face appointments.

The letter, which was signed by then-primary care medical director Dr Nikki Kanani and sent out to national newspapers as a press release, landed NHSE in hot water, with GPs labelling it ‘insulting’.

Speaking on Thursday last week, Mr Hancock suggested that, while he was ‘essentially in agreement’ with where the Dr Vautrey’s letter ‘was coming from’, the GPC had wrongly politicised the issue.

He said: ‘I agreed with the thrust of what Richard Vautrey was saying here but obviously I didn’t agree at all with the political spin that he puts on it. 

‘And, actually, that didn’t accord with my widespread discussions with GPs on the ground, for instance the royal college or GPs in my constituency but, you know, the BMA GP committee is a particular beast.’

Responding to both Sir Sajid and Mr Hancock’s comments on GPs, current GPCE deputy chair Dr David Wrigley said that GPs were ‘instructed’ at the beginning of the pandemic to ‘limit’ face-to-face appointments, and that this was ‘way before any vaccine was introduced’.

He continued: ‘It was the same Government who, mid-pandemic, then pushed practices to return to business-as-usual, ignoring warnings from GPs that it wasn’t yet safe to do so.

‘A small amount of funding was made available to support general practice, but no amount of money could convince GPs to sacrifice the safety of their patients in the interests of hitting Government targets.

‘What funding was allocated to GPs did very little anyway, given the entire NHS went into the pandemic already severely understaffed and under-resourced.’

Dr Wrigley said that GPs were ‘used as scapegoats for poorly thought-out Government policy’ and that this narrative, which was ‘perpetuated’ by the media, ‘completely obliterated morale on the frontline’.

The Covid inquiry has previously heard from the BMA that patients lost confidence in general practice during the pandemic due to the then Government and NHS England ‘appearing to blame GPs’ for access issues.

And experts told the inquiry in September that GPs were left ‘flying by the seat of their pants’ due to a lack of pandemic preparedness focusing on primary care.