After the General Election, what next for the future of primary care?
As Sir Keir Starmer and the new Labour government roll up their sleeves and set out their priorities for the coming months, healthcare is a key issue on the agenda. Having diagnosed that the “NHS is broken”, the government now has the challenging task of trying to fix the problems.
In this article, we examine Labour’s first moves to tackle the crisis in the NHS, including key ministerial appointments, initial actions in office, and pledges for the future. We also look at the reactions from GP leaders and the implications of the ongoing BMA ballot on collective action.
Key appointments in health
Wes Streeting was appointed the new health and social care secretary after narrowly holding onto his seat as MP for Ilford North in Redbridge. Having previously held the role of shadow health and social care secretary, he is positive about the challenge, seeing an “enormous opportunity” to get the NHS “back on its feet making it fit for the future”.
In other government appointments, Stephen Kinnock, MP for Aberafan Maestag and son of former Labour leader Neil Kinnock, is the new minister of state for care, with responsibilities including primary care; Karin Smyth, MP for Bristol South, became the minister of state for health responsible for secondary care.
Andrew Gwynne, MP for Gorton and Denton, has a new role as parliamentary under-secretary of state for public health and prevention while Baroness Merron is now parliamentary under-secretary of state for patient safety, women’s health and mental health.
First steps in power – “The cavalry is coming”
Since taking office, Wes Streeting has reaffirmed the government’s commitment to resolving the crisis in the NHS and general practice. In his article for GPonline, he declared that for GPs considering their future in the NHS, “the cavalry is coming”.
However, he emphasised that restoring general practice will require “both investment and reform.” One of his first actions has been to order an independent review of NHS performance in England to inform his upcoming 10-year plan for the NHS. This will be led by Lord Ara Darzi, an NHS surgeon and independent peer. The report is expected by September.
Mr Streeting’s “number-one priority” for the NHS is cutting waiting times, a point reiterated in the King’s Speech. He has also committed to reversing underfunding in general practice and shifting the focus out of hospitals and into the community. Highlighting this shift, Mr Streeting’s first official visit was to a GP practice – Abbey Medical Centre in North London. He said, “I’m determined to make the NHS more of a neighbourhood health service, with more care available closer to people’s homes.”
Pledges on investment and reform
Labour has been clear that problems in the NHS cannot be fixed ‘overnight’. Money is tight, and any plans need to be affordable. So far, the party has not committed to detailed funding plans for primary care, but Wes Streeting promised: “Labour will provide the investment and reform needed to get patients seen on time again and bring back the family doctor”.
GPs will be watching to see how Labour delivers on its pledges to:
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Train ‘thousands more’ GPs, deliver the NHS long-term workforce plan and ‘reset’ the relationship with NHS staff to end strikes.
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Review the ARRS scheme preventing practices from recruiting GPs.
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Guarantee face-to-face appointments and incentivise continuity of care.
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Prioritise health and care in local communities and trial Neighbourhood Health Centres, bringing together services such as family doctors, district nurses, care workers, physiotherapists, palliative care, and mental health specialists.
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Return to meeting NHS performance standards.
Reactions from GP leaders
GP leaders have welcomed Mr Streeting’s statements and are pushing for further commitments to general practice funding.
The British Medical Association (BMA) England GP committee chair, Dr Katie Bramall-Stainer, called for the general practice share of NHS funding to increase by 1% each year until it reaches 15%. The BMA chair, Professor Philip Banfield offered to work together with Mr Streeting and called for a new and “mutually agreed” GP contract.
RCGP chair, Professor Kamila Hawthorne, was “really encouraged” and said she was looking forward to working with Mr Streeting to ‘ensure that we have the right balance of workforce we need to look after our patients, in particular we need more GPs working in our practices’.
The BMA ballot on the GP contract
Given that Mr Streeting has already engaged with junior doctors, there is renewed optimism that the new government is willing to negotiate with NHS staff over pay. However, a BMA ballot is underway until 29 July, asking GP partners whether they are prepared to take collective action in a stand against the 2024/25 GP contract that was imposed in April and delivered only a 1.9% funding uplift.
Whether GPs vote in favour of collective action remains to be seen, and the extent of any action will depend on negotiations with the new government and their response to the Doctors and Dentists Review Body (DDRB) recommendations on 2024/25 pay.
If GPs vote in favour of collective action, the BMA will invite them to choose from 12 possible actions in the ‘GP practice survival toolkit’ from 1 August. Although this covers a range of options, introducing safe working advice is expected to be the action adopted by most practices.
Meanwhile, the BMA has provided guidance on how to approach the contract changes in practice, and advised members to start implementing the measures to improve patient safety and staff working conditions.
If you would like advice about GP funding issues or the impact of the proposed collective actions, please get in touch with our expert team at Medical Defense Society.
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