Many constituents have approached me in recent months about the pressures in general practice – historic underfunding relative to the rest of the NHS has combined with rising patient numbers, higher patient expectations and the increasingly complex needs of an ageing society. Despite the measures this Government has already taken, and the proposals set out in NHS England’s General Practice Forward View, too many GPs are leaving their profession, and too many are considering doing so in the coming years.
We will not allow primary care to fail - GPs and family medicine sit at the heart of the NHS on which we all depend. At the Royal College of General Practitioners conference in Liverpool last week, the Health Secretary presented the Government's plan for change, including the following core components:
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A new state-backed indemnity scheme – This will provide a more stable and more affordable system for GPs. Delivering on our manifesto pledge, this will provide financially sustainable cover for clinical negligence risks arising from the delivery of all NHS general practice services, by all staff. The scheme will need careful negotiation and there will be discussions about the detail of the scheme with GP leaders ahead of a planned introduction in April 2019.
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Targeted Enhanced Recruitment Scheme - We are offering a one-off salary supplement of £20,000 to GP trainees who start their career in under-doctored areas. This began in 2016, meaning areas with a vacant GP trainee position were filled for the first time in at least three years. Up to 200 additional places will be offered in 2018.
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Physician Associates - announced a consultation on the statutory regulation of our 1,000 additional Physician Associates, who will play a vital role in complementing the medical workforce, releasing time for doctors to focus on the most complex patients and easing workloads in GP practices. To encourage public and professional confidence in the profession, we are ensuring the right regulatory structure is in place to underpin their work.
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More funding – Because successive governments had underinvested in primary care, in last five years this government has ensured that GPs have got an increasing share of the NHS budget. The GP Forward View, published in April 2016, set out an extra £2.4 billion annually for general practice to increase funding to over £12 billion a year by 2020/21 (a 14% increase in real terms). Last year the first £507 million of this growth was delivered, further increasing general practice’s share.
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Practical support - This new money is now paying for practical solutions, including around 500 clinical pharmacists working across more than 650 practices, £30m protecting GPs against rising indemnity costs, and £40 million to support vulnerable and struggling practices. Meanwhile the sector continues to reform itself through new federations and networks, working at scale, including to deliver evening and weekend appointments now for 18 million people.
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Increasing recruitment - Money alone is not sufficient. At the root of the problem is constrained capacity – we need more GPs and other primary care workers. We will deliver 5,000 more doctors working in general practice and already announced plans to recruit 2,000 GPs internationally. Domestically we have record numbers of medical graduates choosing general practice and are increasing the supply of medical students by a record 25% - 1,500 more medical school places every year, focussed on producing family doctors.
We should also remember that last month, the Care Quality Commission gave a positive verdict on the state of General Practice in England. Nearly 90% of practices received Good or Outstanding ratings, while 82% of practices with lower scores have since improved. Patient satisfaction with general practice is at 85% - the highest in the NHS. This is a testament to the continuing commitment of our GPs and we will continue to do all we can to support them, so patients always get the care and support they need.
