General Practitioners: Appointments

Lord Turnberg Excerpts

Thursday 17th March 2016 Grand Committee

[Lord Turnberg (Lab)]

My Lords, I am extremely grateful to the noble Earl, Lord Attlee, for bringing this important subject to debate. I fear that it is now widely acknowledged that the situation in primary care is dire. However, I have to say that my own general practice seems to be an exception; perhaps because it is in leafy Hampstead, perhaps because it has enough partners and staff to withstand the buffeting of the rest of the NHS, and perhaps because it has such excellent leadership. Or, most likely, because it has all three. Elsewhere, in much of the country, general practice lacks all three and the picture is less than rosy. Many practices are small, with two or three partners, and if one goes off sick, retires early or goes abroad, the remaining one or two are stuck in an almost unsustainable situation.

One young GP I know is struggling with just such a burden. She is about to lose her partner, who is retiring early, and she is now running her practice with little or no support. She is finding it impossible to attract any staff to join her and cannot find another GP to come into her practice. There are just too few around who want to work in a less than affluent part of London, despite the Government’s blandishments. It is very hard for her to find other staff too. Meanwhile, she is running around, sitting on committees and the local CCG, as well as dealing with the mound of NHS-inspired paperwork and trying to look after her young family at the same time. Working from eight in the morning until eight at night is an impossible burden to place on anyone. I fear that that is the experience of far too many GPs and it is not much wonder that too many are leaving early and too few are willing to join.

It is absolutely vital that the Government rethink their efforts to encourage and support GPs. Whatever they are doing now is clearly not working properly. Of course, every area of the NHS is suffering from underfunding but primary care, once the beacon of the service, is now merely a flickering candle. If there is anywhere that the NHS needs to see reignited, it is primary care. Of course, a move to larger group practices, with added support, where that can be achieved, would help. But too many practices are too small at the moment. Some GPs gain comfort from being salaried rather than self-employed. That at least cuts down their administrative burden. If it can be made a more attractive option—something the Government might pursue—it offers advantages to some.

Finally, I will say just a few words about research in primary care. I express my interest as scientific adviser to the Association of Medical Research Charities, an organisation whose member charities well understand the valuable role that GPs can play in research. But at the moment too many GPs are so stretched and overworked that there is no way that they can even think about research in the face of everything else they are asked to do. If we are to achieve what Ministers, the Chancellor and even the Prime Minister have spoken about, which is to embed research in the NHS as a major function, and if we are to see what is mandated in the Health and Social Care Act 2012 on making research an inextricable part of the NHS, we are going to have to give GPs all the support necessary for them to be able to fulfil their part. We are still way off that and if, as I understand it, NHS England has not even signed off its research strategy for last year, never mind this year, what hope do we have that we will see any change here? Is there anything the Minister can do to persuade NHS England to do more to support research in primary care and, incidentally, stimulate it into publishing its long-awaited research strategy?

To return to the main thrust of my remarks, is there anything the Minister can do to persuade the Government to look at how we can get general practice out of the black hole it is heading for before it is too late?