The BMA’s GP chair has urged practices to keep the heat on Government via collective action, while the health secretary said he was ‘working rapidly’ to finalise next year’s funding.
In the letter sent yesterday to GPC England chair Dr Katie Bramall-Stainer, Wes Streeting said he wanted to ‘reassure’ GPs that he has ‘heard the concerns’ raised and he does ‘understand the potential implications of the budget announcements for GP practices’.
Arguing that the Government had taken ‘tough decisions to fix the foundations in the public finances at the Autumn Budget’, he added that he wants to be ‘clear’ that they ‘still have decisions to make across the Department about how funding is allocated across the NHS’ – indicating that these will be taken in the ‘coming weeks’.
He said: ‘As part of that, I am working rapidly to finalise the funding envelope for general practice for 25-26. As we undertake this work over the coming weeks, I am keen that we stay in close touch whilst you navigate your own conversations with your members.’
His comments come as Prime Minister Sir Keir Starmer said last week that funding decisions to allay concerns about increased national insurance contributions for GP practices would be made before the end of the year.
In her opening speech to the England LMCs conference this morning, Dr Bramall-Stainer said she was ‘heartened’ by the letter, but added that whilst the budget tax hike issue needs to be addressed, GPs must keep their ‘eyes on the prize’, which is the next contract.
She said: ‘The Secretary of State was very clear with me, he’s asking for time. He’s asking for time to sort this. And I do believe him that he wants to solve it, sort it, because he gets how serious it is. But don’t get distracted. The national contract is a bigger issue still. We don’t want to solve the budget and then get zero for the contract.’
To that end, she argued that GP practices must continue with or join collective action, as GPs ‘are not going to get something for nothing’.
She told the LMC conference: ‘Will we get a new contract? Well, not if we keep on doing what we’re doing, everyone else can up their prices, cut their beds, but we are in a toxic monopoly. All we can do is reduce our services, reduce our staff, reduce our activity, or close our doors…
‘If you were hoping I was a magician and could pull a rabbit out of a hat, I’m not. Government is going to do what government needs to do. We’ve got a new government but we’ve got the same civil service.
‘If you were hoping you could avoid collective action at your practice, because you’re hoping the slightly awkward colleagues down the road were going to do it for you, you need to [join in] as well. ‘If you’re hoping that as an LMC, you’re watching and waiting and trying to keep those positive relationships with your ICB, you’re going to have to take some difficult decisions.’
Mr Streeting’s letter was in response to Dr Bramall-Stainer’s letter earlier this month demanding that GP practices are reassured ‘swiftly’ that increased tax costs due to come into force from April next year will be ‘resourced’ by the Government.
In yesterday’s letter, the health secretary did not specifically mention collective action but he did urge GPs to work together with the Government.
He said: ‘Fourteen years of neglect has left general practice suffering under the burden of a range of pressures and challenges that are hampering the ability of GPs to focus on caring for their patients. The NHS may be in the midst of the worst crisis in its history, but it is only by working together that we’ll get out of it.’
He also said that general practice is and ‘always will be’ a ‘highly valued’ member of the NHS family and will be at the heart of Labour’s plans to reform the health service and deliver a neighbourhood health service.
He added: ‘I know that maintaining the stability of practices in the short term is essential if we are to achieve our ambition of shifting care from hospitals to the community.
‘Furthermore, as you highlighted in our call, we cannot achieve our ambition to cut waiting lists and restore constitutional standards without recognising and harnessing the critical role general practice must play here.’
During her speech to LMC leaders, Dr Bramall-Stainer said she was ‘very glad that Mr Streeting recognises that we as GPs are so clearly the beating heart of the NHS family’.
However she added: ‘If you’re willing to work for free, don’t be surprised whether parts of the NHS take you for granted. So keep focused, keep the faith. Action is growing, it is cumulative, and it is working, but we won’t get anything unless we change, we will get anywhere, unless we start saying no and valuing ourselves.’
Since the chancellor’s budget announcement at the end of last month, the Treasury confirmed that funding has been set aside to protect the spending power of the public sector, including the NHS, from the direct impacts of these changes.
But GPs have been excluded from this, as the funding to offset the increased NICs costs does not include support for the private sector, including ‘private sector firms contracted out’ – with GPs generally operating as independent businesses for this purpose according to the Treasury.
For Pulse’s analysis of the budget, read: A Budget seemingly designed to punish GPs
Actions not words Mr Streeting. GPs are right now cutting back on clinical staff to stave off businesses becoming unviable. This is not good enough. Dr No will consult their last patient in August this year unless you buck up and sort the problem. Or maybe you don’t want to… I may be a potty-mouth here but in person you’ll find me the most efficient, most productive (i.e actual clinical work), and safest clinician in the NHS, not to mention being the one patients want to see, like many colleagues of my age. You’ll miss us when we go.