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House of Lords Hansard
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GP Partnership Review
21 February 2019
Volume 795

Question

Asked by

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To ask Her Majesty’s Government what steps they will take to implement the recommendations of their report GP Partnership Review: Final Report, published on 15 January.

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My Lords, we recognise the huge contribution that general practice and the partnership model has made to patients over the lifetime of the NHS. We wish to thank Dr Watson for the report of his independent review, and we are currently considering his recommendations. We are planning to publish a formal response in due course.

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I thank the noble Baroness for that Answer. The GP Partnership Review makes seven key recommendations, including: an increase in the number of GPs and funding for those roles; an expansion of the range and capacity of healthcare professionals working with GPs, such as developing the role of practice nurses; focusing on general practice in medical training; and recommendations to deal with an unsustainable workload. Those are all laudable aims. What puzzles me is the context in which these aspirations can be delivered. Some 78% of EU doctors working in the UK are not reassured by the Prime Minister’s commitment to protect the rights of EU citizens, and 35% of EU doctors are considering leaving the UK and moving to another country. The tier 2 visa cap means that 1,500 applications for healthcare workers were rejected by the Home Office last year, and indeed more GPs are retiring, leaving or going part time than are entering the profession. So is there a plan to remedy the existing shortfall and the impending shortfall, which threaten and will continue to threaten patient care and safety?

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I thank the noble Baroness for her Question. She is absolutely right that recruitment and retention of GPs is a core priority for the Government. That is exactly why funding for GPs in the long-term plan was increasing at a rate higher than in the rest of the NHS, at £4.5 billion. That is also why we have a target to recruit 5,000 more GPs. I am pleased to report that HEE has reported that we recruited a higher number of GPs last year than ever before. We also have some core recruitment schemes to increase GP retention: the GP Retention Scheme, the Local GP Retention Fund, the GP retention service and the Releasing Time to Care programme, with £30 million in funding. However, we accept that this is a challenging thing to achieve, and we are working hard to improve our performance.

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My Lords, on the subject of GPs retiring, what are the Government going to do about the fact that many GPs are retiring once they reach the age of 55 because their final salary pension scheme exceeds the £1 million limit, which the Government successfully reduced from £1.8 million, and then come back as locums, costing the health service even more? That affects not only GPs but a number of people elsewhere in the public sector, who are behaving completely rationally because they suddenly find themselves being taxed at 55%.

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I am not able to talk about other parts of the public sector, but we recognise that there are legitimate concerns here, and we are working with the BMA and NHSE as part of our work on the recruitment and retention of GPs and consultants, and considering what mitigations, if any, would be appropriate.

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My Lords, this was indeed a good and welcome report. The Royal College of General Practitioners welcomed the findings, but noted that the profession was concerned about red tape surrounding appraisals, CQC inspections and now GDPR, which are all getting in the way of patient care. Who is responsible for squaring the circle between improving patient care and GP regulation and accountability?

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The noble Baroness is absolutely right: we want to free up GPs to do exactly what they have been trained to do, which is to care for patients. That is why, as part of the GP contract, we have included funding to ensure that they can claim for any additional costs that they may have under GDPR. It is also why we put in the long-term plan that we want to recruit an extra 20,000 staff who can provide the other services, such as administrative services, that GPs are sometimes caught up doing when they should not be.

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My Lords, the list of things that the Government intend sounds very impressive. I have a simple question. Communication is particularly important to general practitioners, who may see 90 or 100 patients with abdominal pain, one of whom may have a cancer of the colon. That is one of the major problems. Has the noble Baroness ever sat down and had informal conversations with general practitioners who are threatening to retire, or are retiring, early to understand how they feel about it?

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I absolutely have had a large number of conversations with general practitioners who have struggled. In my previous role as a Member of Parliament, I visited a large number of general practices in my constituency. I am also the daughter of a doctor and I have a rare disease, so I spend a lot of time in the NHS as a patient and, perhaps, as a mystery shopper—so I assure the noble Lord that I have extensive experience of the NHS. I would not claim, however, to understand what it is like to be a general practitioner, so I would always hope to learn by continued experience of listening to their experiences and challenges.

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My Lords, why does the Minister think that the reality that we see every day in the outside world differs completely from what she says at the Dispatch Box?

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I do not think that that is the case. I think we are making good progress. It is a challenging picture for general practitioners; that is exactly why, since the New Year, we have introduced the long-term plan to increase funding for the NHS, and in particular for general practice. We have introduced this review with support from the department, new GP practice with support from the BMA and the new GP IT Futures plan so that we can bring in the most innovative technology for GPs so that they can bring the best and most innovative care to patients.