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General practice crisis threatens to 'destroy the NHS'

The general practice funding and recruitment crisis is a 'hurricane' threatening to undermine the fabric of the NHS, a conference heard today.

BMA GPs committee chair Chaand Nagpaul warned that patient demand, declining recruitment and lack of investment in general practice, which is the 'foundation stone' of the health service, could lead to the collapse of the wider NHS.

He said: ‘This is not just a perfect storm, but an absolute hurricane … a hurricane that will destroy the whole fabric of the NHS if the Government does not act swiftly.’

Dr Nagpaul made the comments in his speech to the two-day BMA local medical committees conference, which began today.

He highlighted how one in three GPs were aiming to retire in five years, while one in five trainees planned to go abroad to practice, according to a BMA survey of 15,000 GPs published earlier this year.

Decline of the GP
Dr Nagpaul added that the numbers of NHS doctors working as GPs had shrunk from 34 per cent to 25 per cent.

He said: ‘The newly elected Government must wake up to this alarming reality, not only because it will fail dismally in its manifesto pledge for 5,000 extra GPs, but crucially because unless it turns this around we won’t have a comprehensive general practice service in parts of the UK.'

Dr Nagpaul said the general election had seen all main parties pledge to increase GP numbers, but that political rhetoric had to be replaced by reality.

He said: ‘I call upon the prime minister to jettison the political pipe dreams of tomorrow and get real about how we resource, resuscitate and rebuild general practice today.

‘It’s absolutely pointless promising 5,000 extra GPs in this parliament if we lose 10,000 GPs retiring in the same period.’

Seven-day services 'obsession'
Dr Nagpaul also said: 'If Government claims to have any clue about the plight of general practice it must halt its obsession [with] practices to open for seven days when there aren't [enough] GPs to cope with demand.

'This would damage quality care by spreading GPs so thinly and will reduce GPs' availability for older, vulnerable patients.'

As well as the challenges in staffing, Dr Nagpaul warned that financial pressures being placed on the profession were proving equally critical.

He told the conference that NHS spending on general practice now stood at less than 8 per cent, while 'brutal cuts' had seen the phasing out of the minimum practice income guarantee.

He added that workload must be the starting point for any new deal for GPs, and that the 12- to 14-hour days being worked were unsustainable.

He said: ‘If we carry on the way we are, we're putting not only ourselves but our patients at risk of care that is lacking in quality and [is] potentially unsafe.’