Why GPs fear they are losing control under Wes Streeting

Telegraph

2 days ago

Wes Streeting has a plan to save the NHS. Unfortunately, it may put him on a collision course with the workforce he needs to deliver it.
In poll after poll, long waits accessing GP care come high on the list. Public satisfaction with GPs is at an all-time low; though in recent weeks there have been small signs of improvement, at least in the numbers struggling to contact their practice in the first place.
The Health Secretary knows that if the NHS relies too heavily on the existing GP model, it may be hard to make radical improvements.
And so, he has drawn up a 10 Year Health Plan, which sets out a vision of 'neighbourhood health' with a health centre in every area; a 'one-stop shop' open six days a week which brings GPs and other services together.
It's an echo of an idea Labour previously tried under Gordon Brown; promising a network of 'polyclinics'.
That was opposed by the British Medical Association (BMA) and as a result failed to get off the ground. And now the BMA is agitating again; with the threat of a fresh dispute this winter, unless GPs are put in charge of the new model.
The plan published by the Government does not actually dictate who has ultimate responsibility for hubs. But in the run up to its launch, Mr Streeting suggested a variety of options were on the table, including allowing hospitals to take over more neighbourhood health.
For the Government, allowing different models to compete – with more family doctors deployed as staff, rather than being self-employed contractors – could stop GPs holding all the cards.
While GPs complain about their workloads, the profession is very reluctant to give up any duties which come with funding attached.
GP partners have average earnings of £110,000, with most opting for part-time hours.
The complex GP contract which pays doctors for every patient on their books, and for fulfilling a series of targets means that change can be costly.
New models of care could provide the Government with a workaround – and give those running centres more freedom to find the workforce they want to deploy.
Dr Katie Bramall-Stainer, the chair of the BMA's GP committee, believes the plans threaten the existence of 'the traditional NHS partnership model of general practice'.
'The current trajectory threatens the survival of the independent contractor model and, with it, NHS general practice and the trusted family doctor relationship our patients rely on and want to protect,' she told ministers recently.
This week she said GPs will re-enter an official dispute with the Government in September if six key demands are not met. These cover pay, contract funding, and how much extra money they will be allocated to run new health hubs, as well as clarification on whether they will be the ones to run them.
And so a winter of discontent looms. Junior doctors – now called resident doctors – have just completed their first strike under a Labour government since 1979.
On Thursday, nurses rejected their pay award threatening a strike ballot unless the Royal College of Nursing's demands are met. GPs – who embarked on 'work to rule' measures last winter, without the public noticing much – will now have to contemplate their next move.