GPs warn face-to-face appointments plan could lead to exodus of doctors

British Medical Association says blueprint could exacerbate GP shortage and see many leave the profession

GP leaders have warned that giving patients guaranteed face-to-face appointments could lead to a crippling exodus of family doctors already exhausted by the pandemic and despairing of being “pilloried” by ministers.

The profession’s key bodies said the government’s plan to force them to see in person every patient who asks will exacerbate the already serious shortage of doctors, especially as the proposal includes “naming and shaming” surgeries that do not comply.

Opposition parties also rounded on the government’s blueprint for change, with the former Conservative health secretary Jeremy Hunt saying ministers were taking the wrong approach.

“This is a burnt-out workforce running on empty,” he said.

The increasingly bitter war of words between GPs and the government escalated further when Prof Martin Marshall, the chair of the Royal College of GPs (RCGP), condemned ministers for implying that family doctors are lazy, despite working long hours and dealing with increasingly heavy and complex workloads.

“The last thing GPs are is lazy, and that goes for other members of our team as well,” Marshall told the Guardian.

“GPs have worked to their limits over the last 18 months, caring for patients in as safe a way as possible,” he added.

He also accused minsters of spreading dangerous myths that telephone or video appointments are inferior to in-person interactions. “The narrative being peddled that remote consultations are substandard to those delivered in person is dangerous. Face to face appointments will always be an essential part of general practice, but good and safe care can also be delivered remotely.”

The British Medical Association said Javid’s failure to push through major changes it suggested to reduce GPs’ workloads “will force many GPs to hang up their stethoscopes and leave the profession for the last time.”

Dr Richard Vautrey, the chair of the BMA’s GP committee, told the Guardian: “This new performance management messaging and potential public naming and shaming will do little to persuade wavering GPs to remain in the NHS, and the constant criticism will do nothing to persuade new recruits to choose general practice.

“After pulling out all the stops, working all hours to provide for patients over the last 20 months, delivering world class Covid and flu vaccination programmes, these latest insults will leave many asking why they bother.”

Javid’s plan, under which GPs in England will receive £250m extra funding if they agree to see more patients face-to-face, was criticised by Hunt, the health secretary from 2012-18.

He described the government’s proposals as a poorly thought-out “sticking plaster” that would not work.

The chronic and worsening lack of GPs meant the plan is doomed, Hunt said. “As someone who tried and failed to get 5,000 more GPs into the system, I don’t think this package will turn the tide,” he said. While he recruited more young doctors to train as GPs, that success was nullified by larger numbers of older family doctors going part-time or quitting altogether, he added.

Official workforce figures published by NHS Digital show that the number of full-time equivalent GPs in England has fallen from 29,403 in September 2015 to 28,023 – a fall of 1,380. However, the overall number of family doctors has risen over that same period from 36,120 to 38,792.

“This is a burnt-out workforce running on empty because of a massive mismatch between supply and demand. The only thing that will convince them not to continue retiring or opting for part-time hours in droves is a clear plan to end the unsustainable pressure they face,” added Hunt.

He said Javid should instead focus on a massive recruitment drive that would include persuading retired GPs who came back into the NHS during Covid to stay. Incentives to entice doctors from abroad, especially Canada and Australia, to come and work in Britain, are also needed.

The outpouring of anger from GPs that greeted Javid’s “GP rescue plan” led the health secretary to pull out of a scheduled appearance at the RCGP’s annual conference in Liverpool at the last minute.

The BMA accused him of “running scared of speaking to the profession face-to-face because he knows his plan is, in reality, no plan at all.”

Opposition parties voiced their fears of even more GPs quitting.

“There is now a real risk that GPs already burned out from working overtime during the pandemic will walk away from the profession in frustration at the government’s attitude towards them”, said Munira Wilson, the Liberal Democrats’ health spokesperson.

“We should not forget the sacrifices many GPs have made to keep us safe. It seems the government have a short memory on this.”

Labour’s shadow health secretary, Jonathan Ashworth, said: “Within minutes Sajid Javid’s promise to guarantee face to face appointments with a doctor completely unravelled.

“By failing to put forward a proper solution there is now a real risk that more GPs could quit in frustration. No wonder the health secretary ran away from explaining himself face to face. Rather than picking fights he should deliver the 6,000 extra GPs he promised as Chancellor.”

Prof Chris Whitty, the government’s chief medical officer for England, struck a different tone to Javid when, addressing the RCGP gathering, he praised GPs as “outstanding”, adding: “I’m massively admiring of what you all have done, and continue to do, in the biggest public health challenge in our professional careers.”

After pulling out of the RCGP conference Javid did a round of broadcast interviews to defend his plan and then visited a GP surgery in south-east London where he lavished praise on family doctors.

Contributor

Denis Campbell Health policy editor

The GuardianTramp

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