Is a serious shortage of GPs the next major crisis to hit the NHS?

Written by Tony Millett.

Many experts believe the next crisis to hit the NHS will be a perfect financial storm which will make landfall just before or just after the 2015 general election.

It does not give much reassurance when, at the end of the last financial year, Wiltshire’s Clinical Commissioning Group (CCG) has to return £5million to the Department of Health – a percentage of its budget that dwarves the increase it was given at the start of that year.

Just yesterday (May 21) the Health Service Journal discovered - under Freedom of Information requests - cases of hospitals asking for extra cash to fend off unpaid suppliers and keep the electricity from being cut off.

However, anxieties expressed forcefully at this week’s board meeting of Wiltshire CCG indicate that there may well be a ‘shortage of GPs’ crisis that will hit the NHS even sooner than the full force of the financial crisis.

With GP numbers down across England, Celia Grummitt put the matter plainly: “GPs are feeling under pressure and under-resourced. We need to send a message to the centre: the NHS is not looking well and they need to do something.”

Dr Grummitt, who is vice chair of the CCG’s Sarum Group and a GP at the Cross Plain Practice with surgeries in Shrewton and Durrington, went on: “We are losing young doctors from this country in droves.”

Dr Toby Davies, chair of the CCG’s Sarum Group, gave an example of the number of GPs opting for retirement in one area set against the number of newly trained doctors leaving the country. He cited the pressures on GPs from the coalition government’s recent contract for GPs.

“The new contract makes it worse.”  How, he asked, were GPs to find the time to fulfil the need for two per cent of their patients to be given individual care plans?

The pressures on GPs do not only come from the new contract.  Under the coalition government’s root and branch restructuring of the NHS to Andrew Lansley’s plan, GPs have been mandated a central role in commissioning – and for some GPs that takes up a considerable amount of their time.  As Dr Grummitt put it: “We are under pressure to get back to the practice.”

So why are newly trained leaving the country?  It is clear that financial rewards for GPs have been reduced.  So to make up for that loss, they are planning to bid to undertake more treatment services in their surgeries – and that puts new pressures on them.

It probably does not help keep them in this country that the government insists on day-to-day micro-management of the NHS and talks down the qualities of the NHS and talks up the value of private, commercial providers.

News of this looming shortage comes hard on the heels of the critical shortage of nurses in England’s hospitals following the 2010 general election: “Number of NHS nurses falls despite coalition pledge to protect frontline – Almost 6,000 nurses’ posts have disappeared since the general election, official figures show” (Guardian – September 2012.)

For hospitals now facing demands to publicise ward-by-ward staffing levels, the nursing shortage is by no means resolved.  Great Western Hospital has not been alone in sending staff to recruit trained nurses in Ireland and mainland Europe.

But we should perhaps remind ourselves that last summer there was a similar ‘doctors shortage’ scare: “Shortage of GPs will undermine the future of the NHS” (King’s Fund – July 2013).  And a few weeks ago it was a shortage of hospitals’ A&E doctors: “Jeremy Hunt has ‘no clear plan over chronic shortage’ of emergency doctors” (Daily Mirror on a report from MPs - March 4.)

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