The BMA has just identified another growing problem that will face the next government, the chronic underfunding of GP practices, and is urging patients to advocate for better support during the election.
The campaign, called ‘GPs are on your side’, warns that general practice is ‘collapsing’, and that ‘every practice across England is struggling to keep its doors open’ – calling on patients to speak up about pressures on general practice during the general election. It argues that GPs agree with patients and the wider public that “nobody should struggle to see their family doctor.”
The campaign explains that GP practices in England receive just ‘£107.57 per year for each patient, whatever their health needs’ – that’s less per day than the cost of an apple. The problems have been worsened by NHS England’s offer of funding that will only pay for “additional roles” staff – but not help to pay GPs or qualified nurses.
GP-led services are at risk, with Pulse online magazine warning of substantial unemployment among GPs unable to find locum posts this summer as practices struggle to cut spending to stay afloat.
The BMA is now balloting GPs on industrial action to challenge the miserable 1.9% increase in their national GP practice contract baseline uplift for 2024/25. To underline the urgency of the problem, doctors at a Cambridge city GP surgery have said they can no longer run it because of spiralling costs and a lack of funding.
All four GPs at East Barnwell Health Centre said they were handing back their contracts as of October: there is no time to lose in addressing the cash crisis that is putting basic GP cover at risk even as Labour promises to “bring back the family doctor”.
GPonline has reported that a doctor who is about to exit GP training in Bolton has looked for work and can’t find any vacancies within 45 minutes of where he lives after approaching every nearby practice. He has a family so can’t move anywhere, and has had to apply to work in Tesco.
GPonline has also revealed that some GP locums had to use a food bank because they were struggling to find work and another GP chose to work as an Uber driver after being unable to find salaried or locum work.
BMA sessional GP committee chair Dr Mark Steggles told the UK LMC conference last month that each GP vacancy was receiving up to 80 applications – and BMA England GP committee chair Dr Katie Bramall-Stainer has said that ‘recent months have seen the emergence of a disturbing paradox: rising GP unemployment in the midst of a GP workforce crisis’.
The Conservatives have now promised to build 100 GP surgeries if they win another term. But even if they did, it would still leave far fewer GP surgeries than the Cameron government took over in 2010. Back then there were 8,458 GP surgeries: now there are just 6,311. That’s 2,147 (25%) fewer: and many of those that are surviving are struggling to keep their heads above water amid rising costs.
GP leaders say practice funding has been slashed by more than 50% in real terms over the past decade and a half.
The number of fully qualified GPs in England has also continued to fall. Based on the government’s pledge of an additional 6,000 more GPs by March 2024, there should have been around 33,800 GPs as of December 2023, but the data suggests there are only around 27,500, 2.2% fewer than in December 2019.
Total numbers of GPs (the figures quoted by ministers claiming that all is well) are inflated by including trainees: these numbers have increased by 7 percent since 2016.
However the falling numbers of fully qualified GPs have meant the caseload per GP has been increasing, rising from an average of 1,947 patients per GP in March 2016 to 2,298 in February 2024 – an increase of 18 percent.
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