The NHS needs more than just money

Boris Johnson has placed the NHS at the heart of his Government’s new programme for the next five years. The Prime Minister’s commitments to the service went a long way to spike Labour’s guns during the recent election campaign. At times, the only attack line Jeremy Corbyn seemed able to deploy was the canard that the Tories would dismantle the NHS and sell it to the Americans as part of a trade deal. The Conservatives have been in power for most of the time since the health service was established in 1948 and had they intended to take it apart they would have done so by now.

But it would be a mistake for the Government to think that defending the NHS is the same as leaving it unchanged. In fact, the opposite is true. Unless there are some root-and-branch reforms then the system itself could well be doomed.

The Government needs to start with a long hard look at primary care, and GPS in particular. Mr Johnson has promised to recruit thousands more GPS to make up the shortfall. But David Cameron made similar promises and yet there are now fewer than ever. As we report today, remuneration is not the issue. A GP in this country is paid up to three times as much as the average employee, one of the widest discrepancies in the Western world.

The problem is the nature of the job. Prof Peter Marshall, head of the Royal College of GPS, recently said it was now “undoable”. Research by The King’s Fund found that just one in 20 trainees planned to be working full time as a GP within a decade of qualifying, with most intending to work between one and a half and three days a week. Some surgeries have one permanent doctor for as many as 11,000 patients.

It is clear that this cannot continue and fundamental reform is required, rather than just extra funding and promises of more doctors that cannot be kept. The role of GPS as the gatekeepers to the NHS needs to be reassessed and patients will have to get used to seeing a pharmacist or physiotherapist instead of a family doctor.

A recent report from health think tanks said the NHS will no longer be able to cope without a major shake-up of GP services. With Mr Johnson’s majority likely to last the Conservatives two terms, and Labour a busted flush, now is the time to grasp the nettle.