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24.03.14

Funding shortfalls leave GPs under ‘threat of extinction’

General practice in the UK is “now under severe threat of extinction” due to an imbalance in funding, the chair of the Royal College of General Practitioners (RCGP) has revealed.

Dr Maureen Baker said the system is “imploding” faster than people realise and patients are already bearing the brunt of the problem.

Her comments come after an RCGP commissioned a survey which revealed that three in five Britons believe the number of patient consultations GPs conduct each day – reckoned to be between 40-60 consultations in the majority of cases – is a threat to the level of patient care provided.

Dr Baker said: “GPs are doing all they can but we are being seriously crippled by a toxic mix of increasing workloads and ever-dwindling budgets, which is leaving patients waiting too long for an appointment and not receiving the time or attention they need and that GPs want to give them.

“Cutting funding to the bone is a false economy – by investing in general practice, we are shoring up the rest of the NHS from collapse. We are fiddling while Rome burns and the four governments of the UK must wake up to the critical state that general practice is now in.”

The poll, conducted by ComRes, also highlighted that over a quarter (28%) of those surveyed say that the last time they tried to book an appointment with their GP for themselves, or a family member, they could not get an appointment in the same week.

About 40% of patients were ‘concerned’ that long waits to see their GP could harm their health. The research also reveals that more than four in five (85%) Britons say that if they had a serious long-term illness they would rather be cared for at home if they received proper medical support.

In response to the RCGP’s suggestion of a funding imbalance, Dr Michael Dixon, chair of the NHS Alliance, said: “We agree with the RCGP that there is a funding problem within general practice, and this has been partly caused by a system that pays GPs a fixed sum and hospitals by activity. Historically too, the NHS has been largely secondary care centric, led mostly by managers and doctors from the secondary care sector. We now need an NHS that focusses much more on primary care and its potential.”

He added that powerful vested interests, and little understanding of general practice at the centre, have colluded to reduce funding and manpower proportionately over the last 10 years.

“If we want general practice that takes on some of the work undertaken by secondary care, and that copes with increasing elderly patients with long term disease, increasingly complex problems and increasing demand, then we need to better value and better resource what has become the ‘Cinderella service’ of the NHS, in spite of the Commonwealth Fund finding it to be one of the cheapest and most cost effective services in the Western world,” stated Dr Dixon, who sits on NHE’s editorial board.

General practice deals with around 90% of contacts with patients in the NHS but receives only 8.39% of the NHS budget, with the rest of the health service budget being spent on hospital treatment and other types of care. According to the RCGP poll, three out of five (60%) of the public would like to see some funding moved from other parts of the health service into general practice.

Following the research, Dr Baker has called for a “proper” provision in the 2014/15 budget rounds – right across the UK – so that GPs can give their patients the care that they need.

She added that initiatives such as the Better Care Fund in England are an important first step in tackling the general practice funding gap and equipping GPs with the resources they need to improve care for the frail elderly. 

“But we need to go further and faster, so that across the whole UK, every patient has equitable access to the high quality care they need and deserve,” Dr Baker added.

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