GP Funding: South-west England

Will Stone Excerpts

Wednesday 25th June 2025 Westminster Hall

[Martin Wrigley (Newton Abbot) (LD)]

I beg to move,

That this House has considered GP funding in the South West.

It is a pleasure to serve under your chairship, Dame Siobhain. GPs are the front door of the NHS. They diagnose and treat illness, prevent disease and provide vital mental health support. As Lord Darzi once observed, general practice displays “the best financial discipline” in the NHS family while constantly innovating to keep patients out of hospital. However, GP funding is complex, obscure and insufficient. The bottom line is that the amount of money GPs receive is insufficient to deliver the obligations they carry. That is a view held by every single one of the 28 practice managers I met in and around my district, who tell me the situation is unfunded, unsustainable and unsafe.

GP funding is broadly based on two elements: a so-called global sum for core service costs, and additional quality and outcomes framework payments. The global sum starts with a payment per patient per year of £121.79—that is less than we might pay for our dog to go to the vet for an annual check-up, or about a third of the cost of servicing a Renault Megane. It is no wonder that practice managers spend their evenings juggling spreadsheets simply to keep the lights on.

It gets worse. That paltry sum is then modified by something known as the Carr-Hill formula. Carr-Hill was designed for a different era. It weighs patient numbers and postcodes but underrates deprivation, multimorbidity and today’s population health priorities. The consequences are stark and deliver what is known as the inverse care law. In my constituency, the Buckland surgery looks after some 4,000 patients on its list but is effectively funded for 3,200.

[Will Stone (Swindon North) (Lab)]

The hon. Member talks about the number of patients that GP practices have on their books. We have an ambitious plan for building more houses. Does he agree that we need to consider not just existing GP practices but funding the infrastructure for future practices, so that we have adequate services for people? There are places in Swindon that will be expected to take on thousands more patients, and the infrastructure is simply not there right now.

[Martin Wrigley]

The hon. Member is absolutely right: we have to consider these things. I have spent many hours persuading my local hospital trusts and the integrated care board to talk to the local authorities and work in the cycles of the local plan, so that they get their requirements into that plan. All too often they say, “A new housing development has just been built. We need a new GP practice with it,” and that is too late. The cycles do not add up. The system is broken, and we need to change that.

The Buckland surgery is underfunded by some 800 patients every year. It is part of the Templer primary care network, in which 2,500 patients are effectively treated for nothing. This means that the Buckland practice faces an annual shortfall of approximately £84,000—money that would cover another GP. If we then look at the changing number of patients per GP, in 2019 each GP was supporting 1,800 patients, compared with around 2,400 today.