Karin Smyth comments on Knowle GP surgery

General Practice receives just 8% of NHS funding but is where 90% of patient contact happens.  Many of us will never be treated in a hospital or community service but we will know our GP surgery.  We expect it to be very local, a short walk away.  We expect to ring up and be seen within hours or at least a couple of days.  General Practice is variously described as the cornerstone, the bedrock or the foundation of the NHS.  It is the most familiar and the most trusted part of the NHS. 

But we are facing a crisis in general practice. 

In March 2011 the respected Kings Fund reported that GP practices lacked the time to address variable performance, develop skills and plan for improvements. 

In July 2013 The Nuffield Trust found ‘significant strain’ on general practice with many GPs facing a daily treadmill of real pressures which meant they were unable to plan and organise for the future.

The Royal College of General Practitioners is running a campaign on the crisis in general practice seeking the views of all GPs and patients.

What was a problem has become a crisis because of the government’s Health and Social Care Act.  The Act has destroyed the NHS organisations which managed our local NHS, it has substituted competition for collaboration and planning and it has taken attention away from developing quality front line services.  It has raised concern amongst the public but the changes were complicated, bureaucratic, and it has been hard for campaigners, journalists and us in the Labour Party to see the visible impact.

This is no longer the case.

Last Monday the patients of St Martin’s surgery in south Bristol received a letter telling them the GPs partners, as a result of being unable to recruit more doctors to the practice, had resigned from their NHS contract. The reality of the crisis in the foundation of our NHS has now directly impacted patients in south Bristol and caused much distress and alarm. 

Every patient has a right to a GP and it is for one of the new organisations, NHS England, to ensure that happens.  Dawn Primarolo, on hearing from worried constituents on Monday, immediately contacted leaders at NHS England to bring together the south Bristol practices to find a local solution.  At the end of the week NHS England responded to say that they could not do that because they were in a tendering process.  This is what the Act has done – competitive tendering processes in place of collaboration and planning. 

The health inequalities, the high level of preventable disease and health need in south Bristol are well documented. Investment in general practice since 2004 had led to a good quality primary care service with improving health outcomes for patients.  We must maintain that high standard and support general practice because without support to the foundation, the cornerstone, the bedrock of the NHS then what has happened at St Martins will not be an isolated case, the rest will soon fall.    

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