The more things change…

Following the Budget, Pulse editor-in-chief Jaimie Kaffash reflects on how Labour’s already underwhelming plans for the NHS seem to have crashed at the very first hurdle

Let me be straight with you. Sometimes it can seem as though GPs see policy announcements that screw over the whole country as being targeted at them specifically.

This isn’t the case with the Budget. Because as our analysis last week stated, it does seem as though this budget was particularly targeted at GPs.

GP practices were denied funding to cover the National Insurance rise because they are, in fact, private sector organisations according to the Treasury. Yet they are not eligible to NI reimbursements that are open to small private sector companies because they are, er, public sectors according to the Treasury.

I’m glad that even the national media picked up on this particularly cruel anomaly. But I am also quite surprised that this media focus – the seemingly one thing that this Labour Party cares about – does not seem to have shifted anything.

But the thing that really strikes me is that Labour’s already underwhelming plans for the NHS seem to have crashed at the very first hurdle.

Let me remind you what they have listed as their priorities: shifting care from the hospital to the community; moving from treatment to prevention; and shifting from analogue to digital. Inspiring stuff.

Yet the Budget seems to have gone completely against the first two priorities. You’re no doubt fearing about your future with these hikes in NI contributions, and we have already had numerous warnings around practices potentially having to close due to increased bills.

And on the second point, I can’t see how continued austerity is going to help prevention. As I have argued many a time, the continued decimation of non-health public services has placed even more pressure on the NHS, and especially GPs. When desperate people have nowhere else to turn, the GP is often where they go.

I have been editor of Pulse for six years, having started here in 2012. I do feel as if I have seen it all before. So my prediction is this: the Government will give a higher-than-normal funding uplift to practices for 2025/26. They will announce it as a funding injection to general practice, to show their commitment to the most important part of the NHS. Meanwhile, GPs, leaders, accountants and anyone with a passing knowledge of the subject will point out that most of that funding uplift will go towards paying the increased NI bill. As a result, practices will continue to see their funding squeezed, unable to afford GPs and patient care will continue to deteriorate. But that won’t be the fault of ministers, who will say they have funded primary care.

At the same time, any attempts to improve prevention will be completely undermined, as the council tenant will develop medical conditions as a result of shoddy public housing, the tighter squeeze on household finances will lead to more mental health problems, and local authorities will not have any funding to put into public health problems.

Maybe I am too cynical. And so maybe it is a good time to announce that this is my last editorial as Pulse editor. I am not going anywhere – I will remain at Pulse, but with a new title of editor-in-chief (and will even write the odd editorial). But the day-to-day running of the title will be in the very able hands of the new editor, Sofia Lind (previously deputy editor).

So this isn’t goodbye as such, more a step back from the nitty gritty (gritty being the operative word) of general practice. It has been a pleasure being so close to GPs – and please do give Sofia as warm a welcome as you have me. 

Jaimie Kaffash is editor-in-chief of Pulse