General practice received £943m less across the coalition's first three years because an increase in spending under Labour was not sustained, according to research by the Royal College of General Practitioners (RCGP). The budget cuts occurred when ministers repeatedly pledged to be protecting frontline NHS care and giving the service real terms budget increases.
While general practice received £8.46bn in 2012-13, that was £405.7m less in real terms than the £8.86bn it got in 2009-10. That fall in funding for GP surgeries means they received £156.45 per patient in 2012-13, 7.1% less in real terms than the £168.40 seen three years earlier under Labour, the RCGP analysis shows.
Dr Clare Gerada, chair of the RCGP, warned that surgeries' declining income was a key reason why patients' waiting times to see their GP were increasing and practices were having to reduce services. "The cumulative effects of year-on-year decreases in funding are now having a disastrous effect on patient care," she said. GPs need an emergency funding package, like the £500m given to help A&E cope, she added.
"GPs are heaving under the pressure of ever increasing workloads and diminishing resources, including a chronic shortage of GPs," she said. GPs' inability to offer patients timely appointments could mean that some patients' illness may be missed, she added. "If we can't see you, how do we know you're not ill?". GP services have become a key issue in the debate over how the NHS, including A&E departments, can cope with rising demand for healthcare at a time when its budget is being squeezed.
Earlier this week, David Cameron pledged £50m to let surgeries in some areas open from 8am to 8pm and at weekends in a bid to ease the pressure on overcrowded emergency departments, while the health secretary, Jeremy Hunt, who is speaking at the RCGP's annual conference today, has criticised GPs for abandoning responsibility for out-of-hours care.
The British Medical Association warned that GP morale was falling because they are increasingly frustrated that time pressures and workload mean they cannot give patients the quality of service they want to provide. "These figures, if accurate, confirm what most GPs experience on a daily basis – inadequate resources to meet ever-rising patient demand, compounded by the pressures of an aging population and care moving out of hospitals and into general practice," said Dr Chaand Nagpaul, chair of its GPs committee.
"The economic and bureaucratic straitjacket that many GPs find themselves in has led to a decline in morale and is unsustainable, with GPs unable to provide patients with the time, access and level of care that they deserve," added Nagpaul.
Andy Burnham, the shadow health secretary, said: "The prime minister has spent all year trying to blame the 2004 GP contract for problems in primary care and A&E. But these figures tell the real story and expose Cameron's spin. These figures are embarrassing for a prime minister who got elected on a promise not to cut the NHS."
Prof Chris Ham, the chief executive of the King's Fund thinktank and a former adviser to David Cameron on the NHS, said the RCGP's figures "show that general practice is taking its share of the pain, alongside every other NHS service, at a time of unprecedented financial pressure." Now that ministers have identified general practice as an area of high priority, they will have to ensure that GP surgeries receive extra resources, he added.
The Department of Health challenged the RCGP's figures. "GPs do a vital job. Investment in general practice increased 1.3% last year, but we know GPs are under pressure to do more with tight budgets. That's why this week we announced a £50m fund for GPs who want to pioneer new ways of working, to help make the best use of their time. We have also asked Health Education England to work towards getting 50% of medical students to become GPs so they have more resources."
Original Article
Source: theguardian.com
Author: Denis Campbell
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