Care minister Stephen Kinnock has joined Wes Streeting in cranking up hostility to GPs who have pointed out that the latest targets for maintaining online access to GP practices every weekday from 8:00 AM to 6:30 PM—outlined in the 2025/26 GP contract—are costly and unrealistic.
Kinnock (in a since-deleted ill-tempered social media post) even urged patients whose GPs fail to offer this service to “take action” against their practice, stating: “What I simply cannot get my head around and what we will not tolerate is the rump of refuseniks and their cheerleaders and the BMA who are intent on whipping up this issue.”
Streeting, speaking at Labour’s conference, described the BMA, who have spoken up on the lack of resources to implement the new policy as the “forces of conservatism”, warning they will “turn the NHS into a museum of 20th century healthcare“.
Dr Steve Taylor of the Doctors Association UK has responded:
“GPs are not being Luddites or trying to obstruct innovation; they have repeatedly increased capacity, but there are limits. Raising expectations without increasing capacity is a folly; worse, it’s lying to patients and pretending that they are on the side of patients. Hopefully, people will see through the soundbites. But sadly GPs will be blamed, held responsible, some will leave, others will breach their contracts.”
Dr David Wrigley, deputy chair of the BMA’s GP Committee, has also pointed out the clear mismatch in government policy as new revelations revealed the failure to improve the timeliness of lung cancer services – posting on social media:
“GPs are being threatened if they don’t reply to an online message within a few hours. However if we diagnose lung cancer, patients wait over 2 months. Where are your priorities NHS England and DHSC? – all patients deserve better but this new attack on GPs is wrong.”
Policy impact
The new access requirements, initially accepted by the BMA but later contested after GPs complained, came into effect on October 1. This was shortly after a damning BMA report on GP practice premises revealed that 50% of respondents regarded their premises as inadequate for current needs; 83% found them unsuitable for future needs, and 74% lacked sufficient space to provide training for new GPs.
By early November, the first data showed the impact of the 8.00-6.30 rule in the first month. In a Pulse and Management in Practice survey of 431 GPs and practice managers, 93% of respondents said their practice had implemented the changes – but almost half (47%) had seen waiting times increase as a result, and only just over a third (36%) said they were able to clear all late online requests on the day.
Some practices had to cancel appointments to make time for reviewing requests, while others needed to extend staff hours. The additional time spent, if spread across the NHS in England, would amount to the equivalent of 200,000 extra appointments a week.
The experience so far would seem to vindicate the GPs who are seeking a pause and a rethink on the new system, and question the judgement of the ministers who insist on charging ahead regardless.
To make matters worse, the controversial 8.00-6.30 open access target has been followed by another challenging new target: the Medium Term Planning Framework published last month commits NHS England to “consult with the profession” on a new “ambition and approach” requiring 90 per cent of clinically urgent patients to be seen on the same day.
Each of these demands requires a GP to have the time either to handle each urgent call or to decide to delegate specific, more minor cases to a suitably qualified professional, continuously for ten and a half hours a day. This could potentially disrupt any additional work that GPs need to do – such as examining and discussing patients, writing and replying to correspondence, checking test results, etc. – as well as the need for proper breaks.
Unrealistically resourced
This would be tough enough to do if GP practices could afford to employ sufficient GPs – but more and more GPs have found themselves unable to get even locum positions, especially after practice budgets were for years skewed towards recruitment of almost anyone other than doctors – through the Additional Roles Reimbursement Scheme (ARRS), which has only in the last year been widened to include payment of GPs.
The fact is that during the lean years of austerity funding the population registered with England’s GP practices grew by almost 7 million (over 12 percent) between 2015 and 2024: but over the same period the number of fully qualified Whole Time Equivalent GPs fell by 6 percent, and the number of practices fell from 7,623 to 6,191, a reduction of almost 19 percent, making primary care less locally accessible in many areas.
As a result, the number of patients per fully qualified GP (and the resulting extra pressure on each GP) has increased significantly, from 1,938 in September 2015 to 2,241 in September 2025 – an increase of over 11 percent. And if any patient is encouraged to expect instant online access at any time of the day, with any request, it’s clear that many of the most heavily burdened practices will inevitably struggle.
This can be seen as a significant increase in pressure on GPs, and, remarkably, they have managed to cope as well as they have. The latest figures show that General Practice delivered almost 900,000 more appointments in September (over 22 weekdays) than in July 2024 (over 23 weekdays) – a 2.8% rise since the change of government.
Of these appointments, GPs themselves (rather than nurses or other professionals) delivered an extra 500,000 in September, an increase of 3.6% compared with July 2024. The number of face-to-face appointments decreased slightly over the same period (-55,000), and telephone appointments fell by 146,000 in September compared with July 2024.
By contrast, there has been a very substantial 1.2 million (76%) increase in the numbers of online/video appointments, to 2.8 million in September. However, this type of appointment remains far less common than the month’s total, almost 8 million telephone appointments, and over 20 million held face-to-face.
Misleading claims
These official NHS figures, from actual cases, flatly and massively contradict the recent claims by the Department of Health and Social Care and the HSJ that online access has now overtaken telephone appointments. These claims are based on surveys of limited numbers within a sample of the population; in this case, the sample seems far from representative, and given the availability of actual numbers, the ONS estimates are not very useful.
Based on these wildly inaccurate figures and disregarding those produced by the NHS itself, Stephen Kinnock makes the misleading comment that: “In the 21st century, patients want and rightly expect to be able to contact their GP online. We know that for the first time ever, more patients are contacting their GP practice online than by phone.”
It’s worth noting, given ministerial rhetoric about concerns over health inequalities, that the HSJ report specifically highlights the significant variation in online uptake across income groups, explaining:
“In the most recent survey, phone remained greater than online for the most deprived quintile; and for those with a minority ethnic background. A smaller share in these groups also report it being “easy” to make contact. The majority also used the phone in the Midlands, North West and – particularly – North East and Yorkshire regions.”
Staffing levels
Mr Kinnock went on to make more misleading claims, notably that “We’ve … recruited 2,500 more GPs.” But NHS data also contradict this. The Kinnock/DHSC figures appear to be based on GP headcount, which is misleading because many GPs only work part-time.
But even at that level, the claims do not match the most recent (September 2025) NHS figures. These show (sheet 1a) a notable increase of 1,897 Whole Time Equivalent (WTE) GPs in total since July 2024, and a much smaller rise in fully-qualified GPs (854). None of the various WTE figures can be interpreted as an increase of 2,500. However, nor do the headcount figures (sheet 1b), which appear to show an overall rise of 2,975 GPs since July 2024, of whom 1,673 are fully qualified GPs.
Political strategy
So far, with ministers invoking the right wing press to highlight the high salaries of a small minority of elite GPs (one-third of the 15,000 partners who own their practices, but around one in eight of all GPs) and by implication whip up hostility to GPs in general, it might appear that the doctors are on the back foot.
In stark contrast with the situation in England, the Scottish government has just agreed a 3-year deal with the BMA to inject £531m for additional recruitment of staff, beginning next year – equivalent to an extra £39 per patient: a similar deal here would be worth £2.49 billion.
But if the 8.00-6.30 requirement continues, month after month, to prove itself to be a massive burden on GP practices, and GP discontent on this begins to grow further, it’s likely there will be more concerted opposition from the outset to the additional plan for 90% of urgent cases to be handled on the same day, leaving the consultation stymied.
Ministerial threats to withdraw contracts from GPs who do not comply could pose an even greater risk to the continuity of GP care in the more deprived areas of the country, where most need healthcare, and where patients are least sympathetic to Wes Streeting’s push to direct all NHS access through the NHS app.
Kinnock calling GPs names and Streeting insulting them won’t help solve the problem. Facing the facts is a basic starting point for progress. Labour ministers would be well advised to start with a proper review of the official NHS figures and to listen to the experts on the front line of primary care, trying to make the system work.
Dear Reader,
If you like our content please support our campaigning journalism to protect health care for all.
Our goal is to inform people, hold our politicians to account and help to build change through evidence based ideas.
Everyone should have access to comprehensive healthcare, but our NHS needs support. You can help us to continue to counter bad policy, battle neglect of the NHS and correct dangerous mis-infomation.
Supporters of the NHS are crucial in sustaining our health service and with your help we will be able to engage more people in securing its future.
Please donate to help support our campaigning NHS research and journalism.
