Bribing GPS won’t fix the NHS crisis

Exhortation, on its own, appears to have failed and so, not for the first time, a government has resorted to a combination of hard cash and tough words in a bid to get doctors to change the way they work for the benefit of their patients. While the Health Secretary, Sajid Javid, has not resorted to “stuffing their mouths with gold” in the same way as Aneurin Bevan bribed the consultants to withdraw their objections 73 years ago to his brand new NHS, neither has he shied away from making plain the Government’s displeasure at GPS’ behaviour during the pandemic.

Mr Javid did not attend yesterday’s Royal College of GPS conference in Liverpool, prompting accusations that he was “frit”. The doctors’ unions are furious at his plans to encourage GPS to perform more face-to-face consultations, with their representatives condemning what they perceive to be “malicious criticism of the profession”.

Only practices that respect patients’ preferences for face-to-face care will be allowed to access money from a £250 million fund. Those that fail to do so, moreover, will be “named and shamed”, although ministers would argue that this is merely about improving transparency for patients. The Government appears to think that this will reverse the decline in in-person consultations, which had fallen to below 60 per cent of appointments in August, from 80 per cent before the pandemic.

Although a review of social-distancing rules within surgeries should remove one of the main reasons why some practices have not been open to the public, it is unclear that Mr Javid’s proposals will be anywhere near enough, given the scale of the problem. Much of the crisis in primary care stems not from a lack of money, despite the protestations of the likes of the British Medical Association and the Royal Colleges. It is due to an overly generous GP contract that has resulted in a rise in part-time, flexible working – much to the detriment of patients.

The health service appears to be ill-prepared for a winter that could see a surge in flu cases, as well as the continuing pressures of Covid and a backlog in treatment that built up over lockdown. This is surely a moment to be thinking radically about how the NHS can best serve the public, including via partnerships with private providers. If the Government is unwilling to do so now, will it ever?