chronic under-funding and under-investment in general practice

The Independent newspaper highlights the hidden problem of gross underfunding down to 6.5% of GDP for the NHS according to the King’s Fund.


Deloitte’s 2014 report for the Royal College of General Practitioners highlighted chronic under-funding and under-investment in general practice. The proportion of money going into general practice, as a percentage of the NHS budget, has been shrinking. At the same time, demand is rising – and ever more services are carried out by GPs. Surgeries have extended opening hours and there has been a shift of hospital care into communities. For example, type 2 diabetes care used to be provided mainly by hospitals but now generally takes place in the community.

As a result, GP workloads are stretched to breaking point. Patients are frustrated as they are unable to book appointments. When I applied to general practice training in 2008-9, it was seen as an attractive career prospect. Fast forward to the present and junior doctors are put off by the prospect of burn-out. Many older GPs are retiring early due to stress. There is a serious recruitment and retention crisis. Unsurprisingly, there is a reliance on locum doctors. Instead of training sufficient numbers, the Government’s strategy will be to recruit more doctors from abroad and introduce physician associates.

To add insult to injury, GP funding to deprived areas is in danger because of government plans to phase out the Minimum Practice Income Guarantee. Furthermore, the new GP contract is in the pipeline. Based on the junior doctor contract, it seems probable that this contract will not deliver what is needed. This would force smaller practices to close their doors. GPs are now threatening mass resignation as the only way of getting the government to listen.

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