Skip to main content

NHS crisis: Government ignores real problems facing GPs.

When governments run out of ideas or wish to avoid major funding decisions they introduce measures that sound good but in practice do little to address the real problems.  The Secretary of State for Health has announced the introduction of 'Osted-style' ratings for GP practices in England.

The announcement received a no-nonsense response from the BMA. Dr Chaand Nagpaul, BMA GP committee chair, said:

“We do not believe that simplistic Ofsted style ratings will lead to any improvement in patient care or give an accurate picture of services in local areas. The Secretary of State needs to also listen to the report from the Health Foundation, which he himself commissioned, which advised strongly against composite indicators which mask the details of quality of care, and which he is proposing now to introduce.”

An ageing population with complex health conditions has increased the burden on front-line services at a time when social care services have been cut.  Cuts in social care has a huge impact on the NHS, where each year £669m is being spent because older people are finding themselves trapped in hospital for days or even weeks.  It also increases pressure on front-line general practice. Since 2010 funding for social care has been cut by 25% leaving a massive deficit in meeting a growing need.  Families are left unsupported.  

Age UK estimates there are more than 1 million left struggling each day without proper support and the numbers continue to grow as cuts in funding leave local authorities struggling to meet needs. A report published by adult social care chiefs (Association of Directors of Adult Social Service (ADASS) earlier this year warned of £1.1bn budget cuts to the sector. Additional funds, it said, are urgently needed to protect services after "almost unendurable" cutbacks in the past five years. Spending on the NHS has remained static at best, whilst funding for social care has been cut by 10.7%. It is a false economy.

This demand is likely to increase as the number of people aged over 65 is predicted to reach 15.7 million by 2031.  We need to fundamentally rethink how this can be met. But we need also to bite the bullet that it will require more and sustainable funding.  The GP crisis is the front line of this deeper problem.

General practice is currently facing a tough financial climate. Since 2008,  General Practice income has declined by 11%  whilst the cost of running a practice (including the amount spent on keeping GP practice buildings in good shape, energy bills for GP practices and the amount spent on GP staff, including practice nurses and receptionists) has risen.

When we hear about GP incomes being high we should take account on one sobering fact.  The cost of running a practice now accounts for 61.6 per cent of total GP income. 

Little wonder then that many GP practice buildings have not seen serious investment for many years, leaving many facilities cramped and inadequate to meet the demands of patients.  A recent survey by the BMA found that  four out of ten GP practices feel that their current facilities are not adequate to deliver basic GP services to patients.

The number of GPs per head has declined from 62 per head in 2009 to 59.2 in 2012 whilst the demand for services increases.   In some parts of the country it is difficult to recruit sufficient GPs to meed local needs. 

As Dr Nagpaul of the BMA has warned,  "GP practices are struggling to deliver enough consultations to their patients because of the unprecedented strain from rising patient demand, falling resources and staff shortages."

The government continues to bury their collective head in the sand in face of this crisis with their false objective of deficit reduction.  It ignores the real issues.  It tinkers at the edges of the NHS and social care problem in England.  Ofsted-style assessment will by like cutting off the legs of a donkey and seeing how it walks.


Comments

Popular posts from this blog

Ian Duncan-Smith says he wants to make those on benefits 'better people'!

By any account, the government's austerity strategy is utilitarian. It justifies its approach by the presumed potential ends. It's objective is to cut the deficit, but it has also adopted another objective which is specifically targeted. It seeks to drive people off benefits and 'back to work'.  The two together are toxic to the poorest in society. Those least able to cope are the most affected by the cuts in benefits and the loss of services. It is the coupling of these two strategic aims that make their policies ethically questionable. For, by combining the two, slashing the value of benefits to make budget savings while also changing the benefits system, the highest burden falls on a specific group, those dependent on benefits. For the greater good of the majority, a minority group, those on benefits, are being sacrificed; sacrificed on the altar of austerity. And they are being sacrificed in part so that others may be spared. Utilitarian ethics considers the ba

The secret life of Giant Pandas

Giant pandas, Ailuropoda melanoleuca , have usually been regarded as solitary creatures, coming together only to mate; but recent studies have begun to reveal a secret social life for these enigmatic bears.  GPS tracking shows they cross each others path more often than previously thought, and spend time together.  What we don't know is what they are doing when together.  Photo by  Sid Balachandran  on  Unsplash For such large mammals, pandas have relatively small home ranges. Perhaps this is no surprise. Pandas feed almost exclusively on bamboo. The only real threat to pandas has come from humans. No wonder then that the panda is the symbol of the WWF.  Pandas communicate with one another through vocalization and scent marking. They spray urine, claw tree trunks and rub against objects to mark their paths, yet they do not appear to be territorial as individuals.  Pandas are 99% vegetarian, but, oddly, their digestive system is more typical of a carnivore. For the 1% of their diet

Work Capability Assessments cause suffering for the mentally ill

People suffering from mental health problems are often the most vulnerable when seeking help. Mental health can have a major impact on work, housing, relationships and finances. The Work Capability Assessments (WCA) thus present a particular challenge to those suffering mental illness.  The mentally ill also are often the least able to present their case. Staff involved in assessments lack sufficient expertise or training to understand mental health issues and how they affect capability. Because of  concerns that Work Capability Assessments will have a particularly detrimental effect on the mentally ill,  an  e-petition  on the government web site calls on the Department of Work and Pensions to exclude people with complex mental health problems such as paranoid schizophrenia and personality disorders. Problems with the WCA  have been highlighted in general by the fact that up to 78% of 'fit to work' decisions are  being overturned on appeal. It is all to the good that they