Warning of mass exodus of Northern Ireland GPs to private sector

BBC News

05-06-2025

A GP who wrote a scathing letter to Northern Ireland's health minister accusing him of "complete disrespect" for general practice has said those working in the sector are at their "wits' end".Dr John Diamond, who has served his community in Magherafelt for 25 years, says GPs are angry about chronic underfunding and unsafe workloads.In his letter to Health Minister Mike Nesbitt, he warned of an exodus from the NHS to private healthcare.The Department of Health said the minister "remains open to discussion as to how best to secure the future of general practice so that it can remain a central part of primary care services now and in the future".
Two weeks ago Nesbitt imposed a disputed funding package that was overwhelmingly rejected by GPs.Nesbitt said a package of £9.5m additional funding was offered to GPs and said he was "disappointed" the BMA negotiators recommended to their members that they reject the offer.A total of 99.6% of GPs who took part in the referendum voted to reject the offer.Dr Diamond, who is based at Garden Street Surgery in Magherafelt and Bellaghy Medical Centre, said "when general practice goes, the NHS goes"."There are now three tiers of patients in Northern Ireland: the people who have plenty of money who can afford to pay, the people who have insurance and everybody else. "Most people fit into the everybody else category."Every day in life I am saying to people I will send them off and they will be seen in six, seven, eight years, in some cases, and sometimes never."I know I will be looking after them for years on end while they never get their treatment."I appreciate that waiting lists are a problem, but they are a symptom of a system of a failing system."He said decisions "that haven't been made properly by our politicians" are to blame.
GP taking 4,000 phone calls a week
Dr Diamond said GPs do more than 90% of all consultations on the NHS. "Up to two years ago, it was 5.4% of the budget, it's probably less than 5% of the budget [now]."He added: "I would argue that if you compare the funding that we get in our region compared to others in these islands, we are very much the poor relation by a long way."Most developed countries would say you should be spending at least 10% of your budget within general practice within primary care and we are far, far from that."Dr Diamond said there are between 3,500 and 4,000 phone calls to and from his surgery on an average week, before they even see a patient.The doctor said he is in the latter years of his career within general practice and had envisaged he would see it out in the NHS."But the youngsters coming through are not accepting that," he said. "They don't want 20 years of a constant battle to get anything done. They want a system that works better for them and better for their patients."For sure, they are plotting what we can do next."He said he would like the minister to "sit down properly with our representatives and have a discussion about the needs that general practice has and respect those needs rather than just dismiss us".
'Matter of regret'
In a statement, the department said it was "a matter of regret" it had not been able to reach agreement in relation to the 2025/26 GMS (General Medical Services) contract. It said the minister stated on 19 May that "he remains open to discussion as to how best to secure the future of general practice."The £9.5m associated with the 2025/26 GMS contract represents additional investment in core GP services, with no 'strings' attached in terms of additional workload, or no requirement for additional patient consultations," it said."Total investment in GP services this year will be more than £414m. "Given the extreme budgetary challenges facing the department, however, the minister has made clear to the BMA that the £9.5m contract offer, which will provide support directly to GP practices in Northern Ireland, was the best and final offer for 2025/26."It added: "The department and minister remain committed to the principle that GP services should remain free to all patients at the point of access and do not agree that the privatisation is the way forward for GPs."