Pulse editor Sofia Lind on what the Government’s plan to dissolve NHS England might mean for the future of general practice
Yesterday the Government proved that it is not afraid of making big NHS decisions. Whilst it had talked about repealing 2012 reforms, completely abolishing NHS England – an organisation employing 6,500 people – is taking its own promise very literally.
The GP leaders that Pulse spoke to gave the news a tentative welcome. Having a direct line to Government instead of dealing with a middleman could make contract negotiations more straight forward, they pondered cautiously.
But what it also does, is give the Labour Government free reign to do whatever they want to the GP contract, without checks and balances from said middleman. And it is worth reminding ourselves that Wes Streeting has said he wants to tear up the murky and opaque GP contract.
Reworking the contract does align with what the BMA wants – it has specifically demanded a letter from the health secretary by next week promising a wholesale GMS renegotiation by 2028 in order to stick to its GP contract deal agreement for 2025/26.
But GPC England does need to be careful with what it wishes for, and the abolishing of NHS England should ring some alarm bells that this Government is more than willing to play hardball. But the timing is convenient. England’s LMCs are meeting for their special conference next week Wednesday, where they will be debating what is next for GP collective/industrial action.
I have a feeling GPCE came under quite a lot of pressure to announce it was no longer in dispute with Government in its negotiations to be given a nearly £1bn increase in GP funding from April. But as we learned quickly afterwards, collective action hasn’t really stopped at all. Partly because it wasn’t really a form of strike at all, but next week’s LMC conference could change that (as illustrated by the legal advice the BMA has sought).
Personally, I would strongly advise LMC leaders to back the BMA to keep the pressure on Government next week. Ideologically, I believe Wes Streeting does want to do away with the GP partnership model (despite flipflopping on the issue) and end the anomaly of general practice sitting halfway outside the NHS. And perhaps the decision to include GP partners in the NICs increase formed part of a longer game plan.
One thing that may act in favour of the current general practice model is the Government’s continued faith in Lord Ara Darzi and the NHS diagnosis he delivered in the Autumn. This pointed out that GP practices are the only part of the NHS which is not running on a deficit.
The best thing we can hope for is that the direct discussions with Government means that ministers listen to GPs and take their vast knowledge and passion for the NHS into account when deciding what GMS contract reform should look like.
Some GPs will have the opportunity to put their questions directly to the primary care minister next week, when Stephen Kinnock MP will make an address and take a Q&A at Pulse LIVE London. I’ll be chairing the session and hope to see as many of you there as possible. And if you can’t make it, drop me a message to let me know what you want me to ask him.
Sofia Lind is editor of Pulse. Find her at [email protected] or on LinkedIn
With huge USA “investment”/expropriation already in the vassal state which we’ve become, I fear everything this centrist BLairabour Govt does to primary care will be at the behest of America as part of back channel trade talks to make it cheaper for US corporations to takeover, eg abolish NHSE and reduce staff costs.
This includes takeover of NHS IT, Data, PCNs etc. The interest of GP principals is absent in any negotiations, so they really need to wake up to this threat..
“Never trust an elf” – says Gimli – but it applies very well to politicians.
The plan is to put pressure on practices. As they fail then the local trust will take them over. Sir James Mackey led a trust that has taken over about 40 failing practices so far. This is bad news for GP partners. Probably worse news for locums. Locums cashed in on struggling practices. Market forces compelled practices to employ cheaper noctors. Now there there are more locums than jobs.
There is some very confused thinking evident in some of the comments on Pulse. Primary care employment in the UK is a “market” apparently. A monopoly funded entirely by government who dictate who can be employed and what they do. A market? Anyone who tries to break free of this monopoly is “cashing in” and when government forbids the employment of Drs by refusing to pay for them, this is just “market forces” at work. Mmm no. This doest make sense. I am convinced theres a good number of accounts on this platform who are probably not Drs/HCPs but here simply to grind an axe or push a particular political agenda. Given GMC numbers are freely available on the performers list website (you need one to get an account) it really doesn’t take much effort for anyone with an agenda to get an account and start posting. Sprinkled in amongst genuine individuals are a group of accounts persistently on here, pushing the same odd clap trap. Its depressing to read and I cant help feeling its bad for the debate. By all means we need a plurality of opinion but thats not what we get here. Maybe its the allied HCP contingent? Me thinks PULSE makes it too easy for the motivated fool. Its too easy to pretend you something you aren’t. Maybe PULSE should go back to showing who everybody is and what role we claim to perform. Could this help frame perspectives and make reading comments a little less of a heart sink?
Thinking about it, Sofia – it’d be nice to have answers to any of these questions from Stephen Kinnock:
1. How much of primary care (practices, data, IT, pharma supply contracts etc) does he think will be owned by foreign companies (esp USA) or private equity, eg Blackstone, in the next 5-10 years (50%, 60% or more) ?
2. Does he foresee NHS assets being split into capital (property, IT infrastructure, data, etc), and into operational? And then being “sold and lease backed” for rent seeking capital?
3. Re the above, what guarantees or mechanisms will the Govt put in place in their “10 year plan” to prevent the NHS from being ultimately owned by foreign entities?
4. Does he agree with his dad, Neil, who was against “mutilation (of the NHS) by corrosive privatisation and underfunding”.
Thanks
Imagine if the government decided to offer a salaried service whose remuneration was comparable to the partnership model.