In full: GPC chair Dr Katie Bramall-Stainer’s letter to health secretary Wes Streeting in light of his accusations that GPs are ‘coasting’
Dear Secretary of State,
I am writing to you following the publication on Friday 31 January of your interview in the
HSJ (‘ICBs must target ‘coasting’ GPs, says Streeting‘). Their unfortunate headline focuses on your quotes stating that there are GPs and practices ‘who are coasting at the expense of those who are striving hard’, and what appears to be a direction to ICBs to restrict funding opportunities to those perceived to be doing so.
The HSJ has yet to publish the second part of your interview, which promises to focus on primary care. If the tone of these comments is reflected in that, then I can guarantee that the concern, upset and disappointment these headline comments have created amongst GPs will only be magnified. I share their disappointment, but also frustration; this is a crucial time when we are negotiating in good faith with your department. Such timing is both unhelpful and poorly judged.
The article doesn’t cite a source for the ‘unwarranted variation’ comment, but given the NHS Digital figures for December 2024 show that general practice delivered patients 28.4 million appointments in that one month, it is clear that the baseline access offered is frankly, exceptional. That our service, as you are aware, is set in the context of fewer GPs offering more appointments to an increasing population with diminished resources from 20% fewer practices than we had in 2013, is astonishing. This is in direct contrast to the 48% increase in consultant numbers across this time.
In my professional experience, variation in GP services is more commonly observed in the face of exacerbating factors: premises that are unfit for purpose; funding formulae which are based on the 1998-2000 Census data; initiatives which adversely impact social equity and fragment continuity; or simply fewer GPs. You and I have agreed that general practice is of critical importance to the NHS, and that it requires urgent support to restore sustainability, rebuild continuity and repair the ‘front door’ to bring back the family doctor as the jewel in the NHS crown.
My sincere wish is to secure a substantive new GP contract within this Parliament that will accomplish this. Such resultant efforts will need the support of the wider profession, and comments painting some colleagues as ‘coasting’ are deeply hurtful, unhelpful, unfair, and unwarranted. I am concerned that any further such commentary will only add to the weight of angry correspondence I have received over the weekend.
We stand ready to work with you to secure what our patients need from general practice. We are actively discussing solutions with your Department at the time of writing.
A swift retraction and clarification will be both welcome and necessary to give these discussions the greatest chance of success.
Yours sincerely
Dr Katie Bramall-Stainer
Chair, GP Committee England
British Medical Association
Performative nitpicking unhelpful, thicker skin useful. What we really want to know: is there any update on industrial in/action, or inside info re how BMA negotiations are going? BMA could take a leaf from proper working-class trade unions in how to run negotiations and action. Or do a tractor run like the farmers (they’re self employed like GP principals).
Having gladly paid taxes all my life and worked in the NHS 34 yrs, I’d like good news soon that traditional GP is saved before I ever need to use NHS. Don’t fancy being told I need to see Pharmacy First, then PAs, then the local hub, then a phone consultation etc. Any cancer I might have, would have got legs and be walking about the neighbourhood by then 😁
We all know a “coasting” GP or two; some have even managed to coast into comfortable roles as tpd or on icb committees, getting generous pay to munch biscuits and drink coffee.