Wes Streeting’s plan to bring down waiting lists by shifting care out of hospital make superficial sense, but if GPs are going to shoulder more of the burden they need the resources to do it, says Katie Collin
GPs have been at the sharp end of the government’s NHS missteps for some time; the persistent lack of foresight, adequate resources and transparency have left them in firefighter mode, scrabbling for answers over how they will make ends meet. Streeting’s plan to slash hospital waiting lists is simply the latest in a long stream of GP-damaging government policies – and it could have a catastrophic effect on our family doctors.
The health secretary understandably wants to bring down the NHS’ 18-month hospital waiting lists, and he has pledged to shift care out of hospitals into communities to do so.
On the surface, this plan has its merits. Taking a preventative approach that makes ongoing healthcare more accessible makes sense, but if more of the NHS load is going to be shouldered by GP practices, they need the government to provide robust resources and set out crystal clear expectations.
There is no doubt that Streeting’s ambitions will increase practices’ foot traffic, especially given plans to revamp the NHS app – and give patients more choice over where they receive non-urgent treatment. Practices won’t just be busier but subject to unruly peaks and troughs of activity, making it nearly impossible to plan ahead.
The issue is particularly acute in light of the staffing crunch practices are experiencing. GP numbers are falling across London, and with fewer people entering the profession, it’s difficult to see how they will meet the uptick in demand.
GP numbers are falling across London, and with fewer people entering the profession, it’s difficult to see how they will meet the uptick in demand
Ultimately, we wouldn’t ask other businesses to step blindly into the new financial year without any idea over their budgets. So, why do we ask this of GPs?
The reality is that they’ve been up against a planning crisis for some time. Just recently, the NI and minimum wage hikes unveiled in the Chancellor’s Autumn Budget raised serious questions as to how these extra staffing costs would be accounted for.
The Treasury complicated matters further by making the argument that GPs are privately owned partnerships and would have to fork out for the increases themselves. As you might expect, this sent many practices into a tailspin. While the health secretary has since hinted that the Budget measures will be considered as new GP contracts are drawn up, he told practices they should simply “hold tight” for funding, stopping short of offering any clarity.
But these near-existential decisions just keep coming. As 2024 drew to a close, the government announced an extra £889m to help GPs tackle their weighty workloads. On the face of it, this was a huge win for family doctors, but, yet again, it seemed to simply be a headline-grabbing exercise with absolutely no detail as to what GPs can spend the money on or when and how they will receive it.
This lack of detail means the announcement was essentially a non-starter. GPs can’t implement the funding into their budgets for the coming year because they’ve been left in the dark. Yet again.
All this means is that GPs are having to run their practices through guesswork. Streeting has been clear that he wants to lean more heavily on primary care, but how does he expect practices to plan for the increase in demand when he cannot provide adequate resources and transparency?
There’s no doubt the NHS needs bold reform, but the health secretary’s plans could bring GPs to critical mass. It’s time to end the long-standing tradition of withholding funding information until the very last second; GPs need clear expectations, sufficient funding, and transparency, or Streeting’s plans to chip away at waiting times will be doomed from the outset.
Katie Collin is a partner at Ramsay Brown LLP, a specialist medical accountancy firm providing tax and accounting services for the UK’s medical sector