Editor Sofia Lind reflects on the year and puts forward her wish for what 2025 might bring general practice
This last year brought a new Government to oversee general practice contracts and funding, however as I write this end-of-year editorial it remains to be seen whether that is good or bad for practices.
Health secretary Wes Streeting cannot stop talking about how he wants to move care into the community in England, propping up general practice and working with the profession. Whether GPs believed him at the beginning of this Government’s term or not, they’ve found it difficult to since the Autumn Budget.
How was it not foreseen that GPs would fall between the cracks of being both NHS and private ahead of the National Insurance contributions announcement, and GPs excluded from the hike from the start? And how was an announcement to say GPs would be excluded or reimbursed not made immediately? These two solutions seem like the common-sense option to me, as I’ve mentioned before, but – as we are well aware – that is not how governments work.
The BMA’s GP Committee was a little bit caught out in their timing for the collective action which they had planned to coincide with a November general election, but they got it off the mark for 1 August, shortly after the Government took their seats at the Cabinet table.
I think Mr Streeting was more than a little bit annoyed by this and perhaps a bit surprised too. At the time, some might have wondered whether not taking a moment to hear the new health secretary out on plans was hasty – however everything that has happened since seems to have confirmed Dr Katie Bramall-Stainer et al were right to plough on with action.
Most recently England LMCs have instructed the GPC to consider escalating to industrial action, in a bid to increase pressure on the Government. But they want a say in this, via a special LMC conference, which is taking months to put together. And, in the meantime, Mr Streeting has hinted that the contract could be announced in January.
Sure, that doesn’t mean industrial action stops being necessary, but it may feel like an uphill battle when it won’t have an immediate impact. But GPs should carry on protesting, as the 10-year NHS plan is still due to be published in spring, ahead of an updated workforce plan.
The fear for these documents would be that they are blue-sky thinking without clear plans for how a shift of funding from hospitals community will take place. This would be entirely pointless, and of little sense, as that ambition has already been set out without any detail.
So that is my wish for 2025: that the Government applies commons sense to all its general practice policies. This could take the form of committing to a new GP contract and funding model in the 10-year plan; and a major expansion of GP training capacity in the workforce plan.
Sofia Lind is editor of Pulse. Find her at [email protected] or on X @sofialind_Pulse
No sense of panic at Richmond house as GPs see an increase in patient satisfaction and GPs see 70 Million more patients than they did last year and demonstrate the ability to do more with less resources We will wait to see who blinks first but as things stand NHS England will manage secondary care contracts and expect ICBs to balance the books
Common sense is absent in the vocabulary of Chicago school neoliberal economics which has dominated since the 1970s.
It looks like this Bliar Govt is also going to continue fragmenting and contracting out the NHS (and the rest of the public sector) to private USA corporates and Saudi Arabia (and probably some shell companies set up by Blair and family), who’ll earn rent in perpetuity. And these private thieves will then turn that NHS debt into complex assets, special purpose vehicles in order to financialise and speculate with the assets, to the point of a future crash. At which point, the Govt will again ask the taxpayers to bail out the private robbers. Our children will be paying the price over their lifetimes.
Unless the Left start offering the politics of values (instead of price value) to build the Great back into GB, then it’ll be “hello Nige”, come 2029.
Increase in global sum to be announced today.
Unfortunately, the situation is far more complex than that. Elsewhere I have argued that there is no logical basis for the wage disparity between primary and secondary care, particularly when primary care plays such a crucial role in long-term healthcare management. There is no way forward for the NHS without restructuring compensation, increasing funding, and strategically training specialists. We need to create a more balanced and sustainable healthcare system.