GP Contract

Luke Evans Excerpts

Monday 16th March 2026 Commons Chamber

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the changes to the GP contract in 2026-27.

[The Minister for Care (Stephen Kinnock)]

When we came into office, we found GP services in an appalling state—underfunded, understaffed and in crisis. Since July 2024, this Government have been fixing the front door to the NHS, investing more than £100 million to fix up GP surgeries this year, making online booking available to patients across the country and recruiting 2,000 more GPs who are now serving patients on the frontline. Following investment in advice and guidance, we have seen 1.3 million diverted referrals since April 2025. Those are people who would have otherwise been added to the electives waiting list. A lot has been done, but there is a lot more still to do. We are determined to make the system fairer for coastal communities and deprived areas, so we have launched a review into the Carr-Hill formula to close the gap on health disparities and ensure that funding is targeted on the basis of need. We will shortly update the House in the usual way on our Carr-Hill review.

Last year’s GP contract saw the biggest cash increase in more than a decade, and this year we are investing an additional £485 million, taking the total investment made through the contract to more than £13.8 billion this financial year. Investment must always be combined with reform, so the new contract will improve access for patients by requiring that all clinically urgent requests are dealt with on the same day. It will provide a mechanism to hire even more GPs via a new practice-level reimbursement scheme, and it will support the shift from treatment to prevention, as set out in our 10-year plan, through incentives to boost childhood vaccination rates, better care for patients living with obesity and requiring GPs to share data with the lung cancer screening programme.

These ideas were not cooked up by someone sat behind a desk in Whitehall. What is happening is that we are taking the best of the NHS to the rest of the NHS, working with pioneering practices that have been doing these things for a long time. Today we can see that our policies are working, and after years of decline in general practice, we are getting the front door back on its hinges. Patient satisfaction with general practice is finally moving in the right direction. According to the Office for National Statistics, almost 77% of people described contacting their GP as easy in January this year, up from just 60%, where it was languishing in July 2024. I know that when he gets up, the hon. Member for Hinckley and Bosworth (Dr Evans) will hugely welcome, as will his hon. Friends, the progress that we are making.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Minister.

[Dr Evans]

The Health Secretary and his team have perfected the sales pitch for NHS reform. The problem is that the detail never seems to arrive. We have seen a 10-year health plan with no delivery chapter, and a plan for the abolition of NHS England with no price tag; the Health Secretary has announced 10 new “straight to test” referral pathways, but could not name a single one; and now we are seeing a new GP contract with more questions than answers.

Calling something modernisation does not make it reform. If the rules and the delivery are unclear, it is simply confusion with branding. “Advice and guidance”, for example, appears in practice to create a single point of access for referrals. GPs will no longer be able to refer patients directly to a consultant, even when they believe that it is clinically appropriate. Will the Government publish the clinical evidence supporting that approach? Who will carry the legal responsibility if, in a GP’s professional judgment, a patient needs to see a consultant but must first go through “advice and guidance”? If advice and guidance becomes mandatory as an extra layer before referral, are the Government not, in essence, managing the waiting list by keeping patients in primary care rather than treating them in secondary care? Waiting lists will look shorter on paper, but patients are simply waiting elsewhere in the system. Can the Minister clarify exactly where those patients will appear in the official waiting list figures? The contract also requires patients whose cases are deemed “clinically urgent” to be dealt with on the same day, but it does not define “urgent” or explain what “dealt with” means, and that really matters.

Let me therefore ask the Minister three clear questions. First, when will the Government publish the clinical definition of “urgent”—a patient’s sick note is urgent for the patient, but not clinically urgent—and what counts as a patient’s being “dealt with” on the same day? Secondly, the Minister has talked about access, but how can practices guarantee same-day responses when demand is uncapped and definitions are not published? Finally, with advice and guidance being required as a mandate beforehand, how will we ensure that patients are protected, and where will they appear on the waiting lists?

[Stephen Kinnock]

I thank the hon. Gentleman for the GP-related questions, for which I was grateful when he finally got to them.

On clinical evidence for advice and guidance, I think that the evidence speaks for itself. We introduced advice and guidance in the last contract with an £80 million investment, and it has been a stunning success. Take-up across the country has been huge, and—this is the statistic that matters most of all—1.3 million referrals that would otherwise have gone to electives have been dealt with by GPs. [Interruption.] The hon. Gentleman, who is chuntering from a sedentary position, seems not to care about what actually matters for patients, but through advice and guidance they are able to get a response from their GPs within about 48 hours. I can assure him that it takes a great deal longer to secure an out-patient appointment. If he is looking for statistics on advice and guidance, let me give him that one again: 1.3 million referrals have been taken off electives and dealt with by GPs. That is part of the hospital-to-community shift.

The hon. Gentleman asked for a definition of “urgent”. We trust our clinicians. We know that general practitioners are experts in their field. They know when they see an urgent issue, but they also know that that the symptoms might be a more acute manifestation of chronic obstructive pulmonary disease, or that a child’s rash suddenly looks more dangerous than it did the day before. We trust our GPs to make those decisions, and it is a real pity that Opposition Members do not seem to do the same.

The hon. Gentleman also wanted a statistic in relation to access. In July 2024, patient satisfaction with access to a GP was languishing at a miserable 60% after 14 years of Tory neglect and chaos. Today it stands at 76%, which is a 16 percentage point improvement. The hon. Gentleman asked for statistics; perhaps he should take that statistic and deal with it.