The HSCC, chaired by former Secretary of State (SoS) Jeremy Hunt, is asking for evidence to inform its recently announced enquiry into the future of general practice. It is interesting that the Committee has chosen this moment to focus on general practice following the sustained attack on the service by some parts of the media, encouraged and supported by the present SoS. Mr Javid clearly requires a scapegoat for the continued struggles of the NHS caused by the Pandemic and its inevitable aftermath, and is deliberately separating GPs from the wider NHS in this propaganda campaign.
The Terms of Reference of this report begin with the issue of access and specifically the impact when patients are unable to access general practice “using their preferred method”, which largely echoes the demand led approach taken by Mr Javid. This is quite mad and to continue in this vein will cause primary care, and probably the rest of the NHS, to collapse under an impossible level of demand. Continuity of care will also be examined and it would be easy for the Committee to conclude that under current conditions this is not being delivered by the traditional model of practice based care, should they choose to take this view.
The report will question whether or not the traditional partnership model is sustainable given recruitment challenges, the move to integrated care and the shift to salaried GPs. The inability of the profession, under its present contract with the NHS, to manage and control workload in order to develop a more attractive partnership option may give the Committee the excuse it needs to conclude that something radical needs to happen. It is obvious that a preventative care agenda within an integrated service may lead them to believe that networks and larger providers may be the solution.
In response, the profession might wish to point out the following:
- A move away from the partnership model will remove the family doctor from the NHS permanently.
- The imminent move to Integrated Care Systems (ICS) is happening too early for PCNs, which have only existed for two and a half years, and which might therefore be overwhelmed and largely ignored rather than form the building blocks of care.
- PCNs’ prime task is to improve the sustainability of general practice and to increase capacity across primary care. The first of these is often lost.
- Patients need to see that post-COVID, general practice will be different but will still provide their only true advocate within the service.
- Patients need to be clear that an impersonal corporate entity will never adequately replicate their practice.
- The containment of GP workload, when the entire NHS is struggling, must be the priority for both practices, PCNs, Government and ICSs. The current stance of the SoS is a genuine threat to our continued contribution to patient care within the NHS.
This report may outline a supportive and constructive recovery for general practice, but the risk of it actually giving Mr Javid the “evidence” he may desire to dismantle what has always been the Jewel in the Crown of the NHS is real and should be addressed. Please follow this link and provide the Committee with your views by no later than 23 December 2021.