GP reform is vital to fixing the NHS
As family doctors threaten winter strikes over his plans to introduce 'community hubs' alongside a new funding agreement, Wes Streeting might take comfort in the observation that he is not the first Labour politician to clash with GPs over their contractual terms.
The first contract between GPs and the health service was based on a principle of 'capitation', with roughly half the income of family doctors derived from the number of patients on their books rather than the amount of work performed.
Today, most GPs still receive around half their income based on the 'global sum allocation formula', which pays out according to the demographic characteristics of a practice's books, with some added payments to reflect regional costs, rather than on actual services.
The result is a system which lacks proper incentives to actually treat patients, and which gatekeeps specialist care behind appointments which are almost impossible to book. Recent analysis from the House of Commons Library showed millions of GP appointments taking place 28 days or longer after their booking. That over 80 per cent of fully qualified permanent GPs now work part-time is surely a contributing factor.
Mr Streeting may or may not have a viable solution to this problem, but he is surely right to conclude, as have many patients, that the status quo is untenable. The hope must now be that he has greater success than his predecessors.
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