NHS England has been ‘stopping’ GP contract reform and its abolition could be an ‘opportunity’ for general practice, the BMA’s council chair has claimed.
Yesterday, the Health and Social Care Committee questioned senior health leaders on the impact NHSE’s proposed abolition will have on the NHS frontline, as well as any potential opportunities the move might offer.
BMA council chair Professor Philip Banfield told MPs that it will not make ‘any immediate difference to the frontline’, since doctors feel that both NHS England and the Department of Health and Social Care (DHSC) ‘have become too detached’ from the NHS shopfloor.
When asked what the BMA would like to see out of the NHSE and DHSC merger to make lives better for staff and patients, Professor Banfield said there were three ‘really quick fixes’, which include a focus on general practice.
‘One is to fix general practice, without NHS England stopping contract reform,’ he told MPs.
Professor Banfield said this is an ‘opportunity’ for general practice, which is ‘the most effective and efficient part of the health service’.
He also pointed to the GP unemployment crisis: ‘You’ve got this complete paradox where you’ve got over 1,000 GPs either under- or unemployed, and yet one of the biggest patient complaints is “I can’t get to see my GP” – how bizarre is that as a situation to be in?’
Professor Banfield’s comments came just a week after the Government formally committed to renegotiating a ‘completely new’ national GP contract by the end of this Parliament. Receiving this commitment in writing was the BMA’s pre-condition for accepting the 2025/26 contract changes.
The Government announced plans to scrap NHS England earlier this month, in a bid to ‘reduce duplication’ and to direct more resources ‘back into the front line’.
Health secretary Wes Streeting said that NHS England will be ‘brought into’ DHSC ‘entirely’ over the next two years.
During the evidence session yesterday, Professor Banfield also stressed the importance of investing in public health, noting that a ‘number of the functions NHS England do currently can be done within a public health setting’, including screening and specialist commissioning.
He told MPs: ‘The frontline feels that what it needs is to be facilitated and enabled. So reallocation of those functions from NHS England or Department of Health to enable doctors and nurses to get on with the job is what is needed.
‘So it’s not a case of cutting that expertise – you need to retain that expertise. The most obvious way of expanding that to the benefit of both the frontline and the population is to invest more heavily in public health medicine.’
Academy of Medical Royal Colleges council chair Dr Jeanette Dickson also highlighted that functions such as medical training should remain as a central function, rather than being devolved as part of NHSE’s abolition.
She said: ‘It’s about how we utilise that national view of education to make sure that there is training opportunities and training happening in every area so the country, not just in the attractive – or what we would call attractive to certain groups – areas of the country.
‘And I think that’s why I would feel that some of the functions of a central education system work really well because they can have that overview of “where are the needs for other healthcare professionals to be trained”.’
Health and Social Care Committee chair Layla Moran said that witness evidence suggested there are ‘some elements and functions of NHSE which must be effectively transferred to’ DHSC, including ‘digital, cyber security and specialist commissioning’.
She added: ‘However, witnesses also emphasised that what matters most to patients and staff is not so much this reorganisation in itself, but what is happening on the frontline every day in hospitals and clinics around the country.
‘They warned that there are opportunities here if done wisely, but if there is no clear direction and plan, the reorganisation risks being pointless.’
GP leaders told Pulse earlier this month that scrapping NHS England may pave the way for simpler contract negotiations, since it removes the middleman between the BMA and the Government, which ultimately dictates funding.
