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29th May 2013

GPs contracts blamed for A&E crisis, but not that simple…

Bruising week puts NHS at the centre of a political row

In what is turning into a bruising week for the NHS, the media is not short of health sector stories stories. For many the NHS is an emotional subject and there is always the danger of over-exaggeration; however many are referring to the current situation as a ‘crisis’:

  • Overburdened out-of-hours care with over-crowded A&E departments
  • Letter from senior A&E doctors at 20 hospitals warns safe care no longer guaranteed
  • Problems with 111 non-emergency service leading to more attending A&E
  • David Nicholson, CEO of NHS England, announces he is retiring in March 2014

This led to Shadow Health Secretary Andy Burnham summoning Jeremy Hunt to the Commons for an urgent session (cue despatch box shouting match) to answer an Urgent Question from Labour on the government’s plans to change the GP contract and the crisis in A&E departments. Mr Hunt went on the offensive blaming the crisis on decisions taken by the Labour government, including “disastrous changes to the GP contract” and the “disastrous failure of Labour’s IT contract”.

Giving evidence to the Commons health select committee, Mike Farrar, chief executive of the NHS federation, the body which represents commissioners’ and providers’ of health services challenged Mr Hunt’s assertion that the GP contract signed under Labour was to blame.

This was also supported by policy expert at the King’s Fund, Nigel Edwards, who spoke to BBC2 Newsnight. Mr Edwards qualified his observation that “…we’ve seen no impact whatsoever really from the new GP contract,” with several observations. These included

increases in A&E attendances being a long-term trend; people more willing to go to A&E now; shorter waiting times and the ageing population. He also said that providing more services like walk-in centres increased demand in the same way that “opening a road seems to create more traffic”.

RCGP supports the government and the CQC

The voice of GPs, which is often missing in the debate or bashed and buried beneath the £100,000 a year salary benchmark, was put forward by Dr Clare Gerada, the Chair of the Royal College of General Practitioners (RCGP). Also speaking on Newsnight Dr Gerada said it was “…unfair to ask a GP after a very busy 11 hour day - a tired GP - to go and then do an out-of-hours shift.”

Dr Gerada also pointed out that the GP contract was almost 10 years old but that the crisis had only arisen in the last few months.

In a separate strand, Dr Gerada has responded to the Health Secretary’s speech on primary care which is due to be given to the King’s Fund on Thursday 23 May. Mr Hunt is to push the case for a Chief Inspector of Primary Care, rigorous inspection and Ofsted-style ratings.

In a press release on the RCGP website, Dr Gerada states that the RCGP supports working with the government and the CQC to devise a system that improves standards. However, whatever shape this takes, she says it must not add to bureaucracy or create a crude system for rating GP practices.

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Click here to see the press release ‘RCGP reaction to Health Secretary’s speech on primary care’ at the RCGP website.

Topics: GPs

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