No 10 set to break promise of 6,000 more GPs in England, Sajid Javid says

Health secretary admits target unlikely to be met owing to numbers of doctors retiring early

No 10 is likely to break its promise to increase the number of GPs in England by 6,000, Sajid Javid has admitted. The health secretary disclosed that the figure, a key promise in the Conservatives’ general election manifesto in 2019, was unlikely to be met given the number of GPs retiring early.

He made the disclosure while giving evidence to the cross-party Commons health select committee. Asked by the committee chair, Jeremy Hunt, if the government was on track to implement the 6,000 pledge, Javid relied: “No. I’m not going to pretend that we’re on track when we are clearly not.”

Increasing the number of GPs in England by 6,000 by 2025 was one of the commitments to improve the NHS Boris Johnson repeatedly made in the election campaign. Others included expanding the nursing workforce by 50,000 and offering 50m more GP appointments a year.

Labour accused Javid of having “casually dropped” the pledge. “It is staggering that Javid has abandoned Boris Johnson’s key election promise to recruit 6,000 extra GPs”, said Jonathan Ashworth, the shadow health secretary. “Patients struggling to get an appointment will be appalled that this promise has been so casually dropped.”

The British Medical Association, which is at loggerheads with Javid over his plan to force GPs to see more patients face-to-face, said unmanageably heavy workloads were prompting growing numbers of experienced doctors to quit.

“The latest workforce figures for England show that we have lost the equivalent of more than 1,800 full-time, fully qualified GPs since 2015, despite pledges to increase numbers by 6,000”, said Dr Richard Vautrey, the chair of the BMA’s GPs committee. “So while the health secretary’s admission today is long overdue, it is absolutely not news to GPs and their colleagues working in surgeries across the country that have been decimated by workforce shortages.

“The bottom line is we are haemorrhaging doctors in general practice. While more younger doctors may be choosing to enter general practice, even more experienced GPs are leaving the profession or reducing their hours to manage unsustainable workloads.”

He blamed the growing numbers taking early retirement on the government’s failure to include measures to relieve the pressure on GP surgeries in its recent plan to guarantee in-person consultations for patients who want one.

“A failure to show any meaningful support for GPs or efforts to retain experienced doctors – something completely absent in the government’s recent ‘rescue plan’ that has been overwhelmingly rejected by the profession – ultimately impacts how easy it is for patients to access their GP practice.”

Javid also:

• Confirmed he is pressing ahead with plans, opposed by GPs, to publish details showing how many patients each surgery in England sees face-to-face.

• Claimed that “a significant proportion of people are turning up for emergency care when they could have gone to their GP”.

• Announced that NHS England would be publishing an “elective recovery plan” by the end of the month to tackle the 5.7m-strong backlog of operations.

• Warned that the coming winter “will be extra tough” compared with normal.

During the evidence session, Hunt recalled how, when he was health secretary, he had to break the promise he had made in 2015 to increase the number of GPs in England by 5,000 by 2020. He attributed that to the increasing number of doctors opting to go part-time or retire early.

He cited the results of a BMA survey published in May, which found that more than a third of GPs planned to go part-time over the next year to reduce their workloads.

Javid’s rowback on the pledge came as research showed that many GPs were cutting back on the amount of time they spent dealing directly with patients in order to protect their mental health.

Exhausted GPs were displaying “resilience surface acting” – pretending to cope with work pressures better than they actually were – in order not to be seen as weak, the study found.

GPs “appear to be resolving this issue by reducing their clinical working hours”, according to the findings, published online in the British Journal of General Practice on Tuesday.

Warning of the “huge implications” of this trend, the authors added: “The cumulative effects of fewer mid-career GP hours worked, combined with increased retirement and reduced intake into the profession from newly qualified doctors, are potentially grave concerns for the stability of the overall GP workforce, the NHS and the health of the UK population as a whole.”

The research was undertaken by Lucy Martin, a GP in the West Midlands, and Almuth McDowall, a professor of organisational psychology at Birkbeck, University of London. They based their findings on qualitative interviews with 27 GPs about their resilience.

Prof Martin Marshall, the chair of the Royal College of GPs, said: “It isn’t surprising to hear that the government are not on track to keep their pledge of 6,000 more GPs by 2024. This has been clear for some time. But it is disappointing. The college has consistently been raising the alarm about the intense workload and workforce pressures facing general practice – and the impact it is having on patients – while the government focuses on ‘sticking plaster’ solutions to address them that do not address the fundamental challenges.”

Contributor

Denis Campbell Health policy editor

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