Health Select Committee highlights confusion among Ministers regarding primary care

On Tuesday 13 January Alistair Burt MP, primary care Minister at the Department of Health, appeared before the Health Select Committee to give evidence as part of their Inquiry into primary care. Mr Burt said that the traditional partnership model of general practice “cannot survive”, adding that Drs want a different sort of life and a different way to carry out their practice. When pushed, he added “A young person going to university now will be entering general practice in about 10 to 11 years’ time, and the world will be very different by then.”

In his evidence the Minister suggested that the GP contract model might not be the best system for the future, admitting that workload pressures and difficulties in recruiting into GP trainee places were having an impact on the profession. Recognising the pressures in answer to a question from SNP Health Spokeswoman Dr Philippa Whitford, the Minister said “I understand that there is only a fixed pool of doctors that can be used. That is absolutely right. I can see the difficulty.”

Asked about the falling overall percentage of the NHS spend that is going into primary care, the Minister said that “the funding commitment of the Government through the manifesto is a £10 billion increase for NHS spending” adding “There is acknowledgment all round—I do not think it is a matter for the Government to hide—that the increase in expenditure in primary care has been lower than that percentage in recent years. It has declined over time. As the recognition of the growing importance of primary care emerges, and as we want to shift more from secondary care, it needs the investment and we are trying to make clear that is where it is.”

The Committee heard that in 2015 one in nine (11%) trainee places left open after three full recruitment rounds, with some areas failing to fill even two thirds of available places. When quizzed by committee chairwoman Dr Sarah Wollaston and GP Dr James Davies MP about whether the Government’s target of 5000 additional GPs into general practice could be met on the current trajectory of GP recruitment, Ben Dyson, Director of the NHS Group at the DH, said that in order to meet the target “we need to increase further the uptake of specialty training” going on to say that if all training places available between now and 2020 were filled, the government would recruit the 4,000 trainees it needs. But the Minister went on to emphatically rule out consideration of a “golden hello” for entrants to general practice.

Commenting on the work of the CQC, the Minister praised Inspectors’ work in identifying poorly-performing GP practices. He said “The CQC regime… has uncovered things that weren’t right and needed to be changed.”

Finally, the Minister defended Government moves toward named GPs, saying “It is going back to one of those things that has been one of the mainstays of general practice. The difference for some doctors between being in general practice and being in clinical practice, where a patient is an episode and one to be dealt with and then move on to the next episode, is that continuity of care, getting to know the family, getting to know the history and all that. I believe very firmly there is real room for that in general practice: that is really important.”

This was the final oral evidence session on primary are taken by the Committee, and follows evidence from RCGP, BMA and CQC just before Christmas. All of the evidence can be accessed via the Committee’s website.

Last updated : 19 Jan 2016

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