DAUK welcomed the appointment of Cooper as an opportunity to restore trust, strengthen public services and place patient safety at the heart of NHS reform.

Dr Matt Kneale, DAUK co-chair, said: “The NHS does not lack the commitment of its staff. It lacks a coherent settlement that enables enough doctors to train and stay, protects patients when they are most vulnerable and gives clinicians confidence that policy is driven by evidence rather than short term expediency.”

Dr Steve Taylor, DAUK GP co-lead, added: “We welcome Yvette Cooper into her role as the new Health and Social Care Secretary, and look forward to the opportunity to work with her.

“She takes on the role with so much to do and many in the NHS workforce disillusioned.

Collaboration and listening

“We look forward to a new day of collaboration and listening to the people who work in the NHS and patient voices. Top down reorganisation and implementation is not the answer.”

With GPs and consultants in dispute with Government, waiting lists still at record levels and pressures across the system, it’s important that she understands the challenges ahead.

“The previous spin of success hid a lot of issues but there are solutions to be found in collaboration.”

DAUK has asked Cooper and new Prime Minister Andy Burnham to make five commitments to healthcare.

Five commitments

• End the medical training bottleneck. Publish specialty by specialty training numbers, fund a credible expansion to meet medical school output and NHS need, and guarantee fair progression for doctors already serving the NHS, including SAS doctors and locally employed doctors.
• Guarantee doctor-led assessment where it matters most. Set national standards so that patients urgently referred by a GP, and patients with undifferentiated symptoms in hospital, are assessed by a doctor or have discharge approved by one. Non-doctor roles should complement doctors, never replace medical assessment.
• Rebuild the family doctor model. Properly fund general practice to provide timely access, continuity and safe clinical decision making. Pause unfunded or unsafe access requirements until they have been independently safety tested and properly resourced.
• Restore fair and independent medical regulation. Remove the GMC’s separate power to appeal decisions of its own tribunal, protect the independence of the MPTS and ensure independent oversight sits with the Professional Standards Authority. A regulator cannot credibly be investigator, prosecutor and appellant.
• Treat the climate and nature crisis as an urgent health crisis, ensuring health infrastructure is adapted to be safe in extreme heat by introducing enforceable maximum safe temperatures for healthcare facilities, delivering a public awareness campaign on the relationship between climate change and health, and supporting an accelerated program of decarbonisation and nature restoration for health.

Dr Kneale said: “These are practical, deliverable reforms that would improve patient safety, retain skilled clinicians and demonstrate that the Government is listening to those delivering care every day.

“We would welcome an early meeting with you and your team to discuss how frontline clinicians can help shape and deliver this programme.”

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

DAUK notes that in his statement, Streeting cited the government’s unpopularity. However, many NHS staff will feel he had become an increasingly unpopular health secretary.

There has been a growing sense that the concerns of frontline NHS workers, and in particularly doctors, were not being listened to or addressed.

DAUK hopes that whoever succeeds him will take a more collaborative approach and will genuinely listen to NHS staff.

Ten Year Health Plan concerns

DAUK has raised concerns about several aspects of the Government’s Ten Year Health Plan, including the increasing role of the private sector in NHS delivery, unresolved issues around pay and working conditions, training.

There are also concerns linked to the Single Patient Record, the involvement of Palantir Technologies in NHS data systems, and the lobbying of Government by corporations and private individuals .

The challenges facing the NHS are significant, and meaningful reform will only succeed through partnership with the workforce delivering care every day.

Meaningful engagement

Dr Matt Kneale, DAUK co-chair, said: “Doctors do not need another period of headline-driven reform, rushed announcements, or policy made without meaningful engagement with the workforce.

“The next health secretary should begin by rebuilding trust, meeting frontline staff, listening without defensiveness and recognising that patient safety and workforce morale are inseparable.

“That means tackling unsafe scope creep, ending the use of ACPs as substitutes for doctors on medical rotas, being honest with patients about who is providing their care, and engaging seriously with the profession to avoid further industrial action.

“It also means addressing doctors’ concerns about the impact of the new draft GMC order, which appears to reverse years of agreed progress on how health regulators should interact with their registrants.”

Stability and leadership

Dr Sarah Jacques, DAUK GP co-lead, said: “During a time when we desperately need stability and leadership, I am concerned about the chaos that we are seeing again.

“However, I am not sad to see the resignation of a health secretary who has shut down the voice of general practice and made conditions for GPs and patients so much worse.

“I look forward to a new health secretary who is prepared to work with GPs and appreciate the genuine worth that we bring to the NHS.”

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

Attacks on BMA

Dr Hussain said ‘direct and personal attacks’ by the Health Secretary had ‘publicly undermined the BMA’s reputation’. They may ‘constitute a breach’ of the Code of Conduct for MPs, he said. Those attacks include Mr Streeting comparing the BMA to a ‘cartel’ at the NHS Providers conference in November. At the same conference, Mr Streeting said the BMA was ‘no longer a professional voice for doctors’.

Moaning minnies

Dr Hussain’s letter highlighted other instances. They included a recent interview with Sky News, in which Mr Streeting accused the BMA of ‘juvenile delinquency’ and behaving like ‘moaning Minnies’. Dr Hussain said: “As a result of these remarks, the reputation of the BMA, a respected professional body, has been publicly undermined. “The language used was strongly derogatory, dismissive of the organisation’s professional standing, and appears intended to degrade public confidence in the BMA’s role.” DAUK has given its backing to the letter.

Health Secretary

Co-chair Dr Ellen Welch said: “The attacks made by the Health Secretary on a number of occasions aren’t what the public expect from their MPs, and certainly not from a secretary of state. “His comments are unnecessarily unpleasant and hostile. “The BMA is a democratic organisation and its representatives have been voted for by its membership. “Therefore attacks on the BMA, such as accusing it of juvenile delinquency, are attacks on its membership of highly-trained, highly-skilled, and highly-motivated doctors.

Code of Conduct

“We support the calls for the Prime Minister to investigate whether they constitute a breach of the Code of Conduct.” Read the letter in full below. All of our committee members are volunteers. They speak to the media and campaign on the issues facing doctors in their own time. Please support their work by joining DAUK or donating to our GoFundMe. [pdf-embedder url=”https://dauk.org/wp-content/uploads/2025/12/Sir-Keir-Starmer-letter.pdf” title=”Sir Keir Starmer letter”]

The letter to Wes Streeting follows the imposition of a new GP contract variation from 1 October, and warns that the contract is a risk to patient safety.

It has been signed by almost 600 GPs and patients, with more than 150 copies sent to individual constituency MPs.

If general practice fails, the NHS fails

The message in the letter is clear: “If general practice fails, the NHS fails. Don’t let this happen on your watch.”

The new contract requirements demand that GP practices provide online access for patients with no corresponding investment, staffing, or infrastructure support.

Dr Ellen Welch, DAUK co-chair and a GP in Cumbria, said: “Every day, around 1.4 million people get appointments at GP practices compared with 67,000 attending A&E.

“People are getting through, we just don’t have enough capacity to see everyone.

Safe capacity

“Many practices are already operating beyond safe capacity.

“Opening up a new access route has simply created further demand that cannot be absorbed without more GPs and capacity.

“Instead, non-urgent consultations are being cancelled, staff are working late, and patients are waiting even longer.

“Clinicians are already under huge pressure and there’s a danger they will be stretched to breaking point and practices just won’t be able to cope.

“This hasn’t been fully thought through and we urge the Health Secretary to think again.”

DAUK letter

The letter to Mr Streeting calls for:

• A pause in the implementation of online access until full impact assessments and safety reviews are completed
• Proper resourcing for online access routes and service obligations. The GPs required to repair general practice exist – but the funding to employ them does not
• Support for a genuine dialogue with GP leaders, and to actively listen to the concerns that GPs are sharing through them

It concludes with a stark warning: “This contract variation does not modernise general practice, it destabilises it. And once lost, the community-based model of family medicine that defines the NHS will not return.”

The letter is the latest stage in a long-running campaign by DAUK’s GP committee. The campaign which aims to address the disconnect between policymakers and the realities faced by GPs.

Why Can’t I See My GP?

A copy of the book Why Can’t I see My GP?, written by Dr Welch, was sent to Mr Streeting, to every member of the Health Select Committee, and to all MPs who are doctors, following last year’s General Election.

Why Can’t I See My GP? highlights the crisis in general practice and offers some workable solutions.

Dr Steve Taylor, DAUK GP co-lead, said: “GPs have been called laggards and refuseniks for raising concerns about the new contract, our working conditions, and ultimately patient safety and satisfaction.

“We’re anything but laggards and refuseniks, and are providing 20% more appointments than a decade ago with fewer GPs.

Workable solutions

“But hundreds of GPs have signed our letter to say it can’t go on.

“DAUK’s GP committee has decades of experience and has put together workable solutions which we have shared with politicians.

“We’re here and ready to work with Mr Streeting and his team to solve the issues facing general practice.”

Read the letter to Mr Streeting.

DAUK GP committee

The DAUK GP committee is a group of volunteer GPs who advocate for general practitioners by addressing funding, workforce, and patient access and safety issues.

GP committee members provide briefings for politicians and develop policy proposals for improving general practice.

Members regularly raise awareness in the media of the ongoing GP crisis while countering misinformation and incorrect narratives around general practice. Please support their work by joining DAUK or donating to our GoFundMe.

The letter to Wes Streeting, signed by a number of organisations representing NHS doctors including DAUK, calls for urgent reforms to workforce planning.

The letter highlights the findings of a recent British Medical Association (BMA) survey showing more than half of doctors completing foundation training in 2025 will not have secured employment.

Financial catastrophe

This represents not only a personal and financial catastrophe for thousands of newly qualified doctors, but also a major risk to patient care in an overstretched NHS.

“This is not just a statistic,” the letter states. “It represents a looming workforce crisis in the NHS.

“Thousands of newly qualified doctors, trained at great personal cost and national investment, are poised to enter unemployment while the health service struggles under immense clinical demand.”

The letter cites Health Education England (HEE) figures that in 2025 more than 30,000 doctors applied for just 10,000 training positions.

Training posts

The government has pledged an additional 1,000 training posts over three years, but this figure, while welcome, ‘is far from sufficient’, the letter says.

International recruitment is another key issue. The letter criticises the government’s encouragement of international medical graduates (IMGs) to sit the PLAB (Professional and Linguistic Assessments Board) exam without a guarantee of employment or career development.

It argues this risks creating false hope for doctors from abroad while worsening the UK’s own workforce bottleneck.

The letter also raises concerns over the expansion of medical school places without a corresponding increase in postgraduate training opportunities, as well as the growing reliance on physician assistants (PAs) in roles traditionally held by junior doctors.

Physician assistants

“The fast-track integration of PAs into clinical teams, often in roles traditionally filled by early-career doctors, has caused concern among junior doctors, especially given disparities in training, regulation, and accountability,” it warns.

DAUK and the letter’s signatories are calling for a package of urgent reforms, including:

• Substantially expand specialty training numbers to match domestic graduate output and wider NHS needs
• Regulate PLAB intake so international recruitment aligns with the system’s capacity to provide fair and structured career progression
• Clarify and regulate the role of PAs, ensuring their work complements not replaces early-career doctors
• In rural areas where the demand for healthcare is high compared to the number of available providers, it is essential to ensure a fair distribution of resources. Special focus should be given to geographically underprivileged regions, supported by attractive incentives to encourage healthcare professionals to serve there

The letter warns ‘the combination of over-recruitment, inadequate training opportunities, and unclear workforce planning is leading to disillusionment’.

Many young doctors may be forced to leave the profession or emigrate to countries such as Australia, Canada, and the Gulf states, ‘where their skills are valued and career progression is clearer’.

System failure

The letter concludes: “The NHS stands at a critical juncture. Without decisive intervention, we risk losing a generation of doctors – not from lack of talent or commitment, but because the system failed to offer them a viable future.

The letter requests a formal response from the Health Secretary within three months and offers to meet to discuss potential solutions.

Read the letter in full below.

Please support our work by joining DAUK or donating to our GoFundMe.

ARRS restrictions

He said: “As Mr Streeting clearly highlighted, the link between health and social care is important, and removing barriers to innovation is key at national and local levels. “GPs are in a unique position of being at the centre of patient care and links to other services. “As an example we would again ask that restrictions on ARRS (Additional Roles Reimbursement Scheme) be lifted on GPs. “Currently it’s only for GPs up to two years post-qualification. It seems this is an obvious top down issue that needs removing.” Mr Streeting said that one of the things he was most proud of since becoming health secretary was the ‘work with GPs’.

Frontline GPs

He said: “‘It’s not just that we’ve been able to deliver the biggest uplift in funding for years or the satisfaction of seeing a decision I took in my first weeks translate into more than 1,500 GPs employed on the frontline already as a result. “It’s actually the fact that we agreed a contract rather than imposing it, committed to further reform together, and it feels like we’re building a real partnership with the profession.” Dr Taylor has questioned the accuracy of the figure of 1,500 GPs, most recently in DAUK’s response to the spending review, saying thousands of GPs cannot find work.

Collaboration

But he said DAUK’s GP committee was grateful to Mr Streeting for highlighting the significant contribution of GPs in his speech. Dr Taylor said: “Although as he suggested there is a long way to go in terms of recruitment and retention of GPs in the workforce, there is a role for GPs to be involved in the development of the NHS in the next 10 years. “It is vital that collaboration between organisations continues, with those in positions of responsibility listening.” Support our work by becoming a member or donating to our Go Fund Me.

Lack of plan

“Sadly a lack of a plan seems to be the message we are getting. “Even worse, the one that has been implemented so far, in the National Insurance employer contributions, has not been thought through leading to higher costs for social care, charities and GP services. “It is time to take health and social care out of politics altogether. The five-year cycle of government is destroying the services the public needs.” DAUK’s comments follow the announcement of the independent commission, which will be led by the cross-bench peer Louise Casey and split into two phases. The first phase will identify critical issues and recommend medium-term improvements and will report by mid-2026. Phase two will look at how to organise care services and fund them for the future, but it will not report until 2028.

Concerns

Elsewhere, a survey conducted by Ipsos on behalf of the PA news agency found that more than eight in 10 people said they have concerns about the health service overall, with half not confident the Government’s plans for the NHS will lead to improvements in the next five years. The chief concerns were: A&E waiting times (68%); as well as long waits for GP appointments (63%); planned hospital appointments (62%) and ambulances (62%). About half of those with concerns said they are worried about the workload on healthcare staff (52%) and the quality of care being delivered (49%). Some 38% said they have concerns about the NHS’s ability to recruit staff, while a third said they were worried about the wellbeing of existing workers. Dr Ellen Welch, DAUK vice chair, said leaders with a proven background in health care should be appointed to focus on solutions that work for the NHS. Dr Welch said: “We have been calling for some time for a cross-party collaboration on the NHS. “It needs a dedicated group of leaders who can make long and short-term plans for our health service that are not dependent on party politics.

Solutions

“Every time the government changes we have reviews and reforms which feel very much like deckchairs being shuffled on the Titanic. “Appoint people with a proven background in healthcare and NHS leadership who know the pressure points and can adopt solutions for the good of the service, rather than schemes that focus on grabbing votes and headlines.” Please support our work by becoming a member or donating to our Go Fund Me.

GP employment

“And we remain very concerned about the implications of the ongoing employment of GPs through the additional role reimbursement scheme (ARRS). “We need more detail and are concerned this is nothing more than smoke and mirrors.” Dr Steve Taylor, DAUK GP spokesperson: “We cautiously welcome the extra funding, but it fails to address the fact that general practice has had a 20 per cent real terms cut in funding per patient over the past eight years. “GPs are now doing 20 per cent more work than before the pandemic – so we’re doing much more for much less and it needs addressing. “The additional role reimbursement scheme (ARRS) GP recruitment programme is failing to meet the needs of underemployed GPs, particularly those looking for the security of permanent jobs in practices. “Depending on reports, there have been between 60 to 300 GPs employed by the scheme to date at huge expense.

GP funding

“The money would be better spent if it was put into core GP funding.” Dr Alison George, DAUK GP committee member, said: “The concern is that the Department for Health is trying to employ more GPs through ARRS, effectively making them employed by the government on low pay and poor working conditions. “There are around 3,500 full-time equivalent GPs available to work now. Why would the government refuse to fund jobs for them but continue to fund approximately 2,000 physician associates (PAs) in general practice? “Funding GPs, who can give patients holistic care, is the best use of the ARRS funds for PAs and will keep more patients out of hospital. “The money needs to be put back into core budgets and let practices employ the GPs they need.” Dr Ellen Welch, DAUK vice chair and a GP, said: “We have repeatedly called for ARRS funding to be reallocated to restore core GP funding – and do so again.

Darzi review

“Lord Darzi’s review pointed out GPs are the most financially disciplined part of the NHS, and we have the unbelievable situation where thousands of GPs are unemployed or underemployed. “The billions of pounds being spent on inefficient ARRS that fragment care should be reallocated into core general practice. “We need to be able to use our budgets to meet the needs of our patients and communities, and to increase GP numbers for safer ratios of patients to doctors.” Dr Sarah Jacques, DAUK GP committee member, said: “It’s a very uncertain time for practices with many being forced to close or on the brink of closure.

National Insurance contributions

“This money will all be eroded unless the government fully reimburses GPs for the increased National Insurance contributions and we see an uplift in the DDRB (the Review Body on Doctors’ and Dentists’ Remuneration) recommendation for GPs’ rates of pay. “Without those we’re set for another year of defunding.” Support our work by becoming a member or donating to our Go Fund Me. Read more on Mr Streeting’s announcement.

Ms Fernandes says avoidable harm costs the NHS hundreds of millions of pounds each year in insurance, additional treatment, and compensation for patients.

The HSJ last week reported that the ‘costs involved in managing accidents that could be avoided’ neared £3bn per year.

Ms Fernandes said: “Patient safety issues must be at the top of any agenda for the NHS.

“Avoidable harm is costing the NHS hundreds of millions of pounds every year. That is money that’s desperately needed to treat patients, to improve pay and conditions for staff, and to invest in infrastructure.

Patient safety

“Which is one of the reasons DAUK has been warning about the potential for patient harm with the roll-out of physician associates.”

Ms Fernandes comments comes as Health Secretary Wes Streeting today announced the introduction of NHS league tables as part of a package of reforms.

Mr Streeting told the NHS Providers’ annual conference there will be a review of performance, with providers placed into a league table.

Persistently failing managers will be replaced. Turn around teams will be deployed to help providers which are running big deficits or poor services for patients. They will be offered urgent, effective support so they can improve their service.

NHS league tables

Ms Fernandes said: “While holding managers to account is good, I am not in favour of NHS league tables. There is no evidence they actually work.

“Learn Not Blame and a just culture in the NHS do not seem to be at the root of this. And it could demoralise staff.

“Agendas, toxicity, and undervaluing staff with misuse of investigatory and disciplinary and discriminatory practices need to be stamped out.

“We need a just culture to improve morale, productivity, and ultimately patient outcomes.

“At a higher level, decisions taken on GP funding and on physician associates need to be addressed.

“Those who created these scandalous costly unproven schemes also need to be held accountable.”

Read the response to Mr Streeting’s speech from our GP committee.

Read Mr Streeting’s speech in full.

General practice

Dr Ellen Welch, DAUK vice chair, said Mr Streeting’s speech to the NHS Providers conference made no mention of GPs. This was ‘despite Lord Darzi’s report advising him to invest in general practice’. She said: “In England, the number of medical staff working in hospitals has increased by thousands while general practices have closed in their hundreds, and the primary care workforce is shrinking with almost 2,000 fewer GPs than we had in 2015. “Despite this, an average of 1.4 million GP appointments per working day were delivered between March 2023 and February 2024. “Mr Streeting is looking for better value for money. General practice is already providing remarkable value for money and with proper funding can provide even more.” Dr Lizzie Toberty, DAUK’s GP lead, warned the proposals may demoralise staff. She said: “I broadly support more accountability for managers. “Helping struggling trusts rather than demonising them is vital to reducing the toxic culture which exists in so many.

NHS league tables

“However, when did league tables in health or education ever improve care? They solve nothing. In the worst cases they will demoralise staff and encourage manipulation of the figures. “The announcement is massively avoiding the elephant in the room, namely National Insurance contributions which are about to collapse general practice.” Dr Welch echoed Dr Toberty’s concern league tables would hit morale. She said: “Introducing league tables sounds like a sure fire way to demoralise hard working staff even further. “No one goes to work in the NHS to do a bad job. I worry these plans are going to create more problems for trusts that are already struggling.”

Postcode lottery

Dr Sarah Jacques, DAUK GP committee member, said many factors might contribute to underperformance. She said: “A rewards system feels like a postcode lottery with the ones doing well getting more funding and the ones doing badly getting funding cut – and then getting worse. “Tertiary centres may end up with worse outcomes due to more complex cases with higher risk. “There are too many factors that can’t be directly compared. Different demographics, poverty levels, functioning versus non-functioning local authorities. “League tables oversimplify it all.” Dr Rosie Shire, DAUK GP committee member, added: “We already have Care Quality Commission (CQC) ranking hospitals in a similar way to Ofsted. I don’t think that has helped improve things. “How will league tables show anything different to CQC ranking? And how will it all impact upon the mental health of staff?”

GP investment

Dr Steve Taylor, DAUK GP committee member, said he was ‘somewhat surprised’ Mr Streeting failed to mention GPs in his speech today. He said: “By the end of today 1.4million people will have consulted in general practice and half the population by the end of the month. “A continued focus on secondary care fails to address the problem, that with just 5.6 per cent of the NHS budget going to GP practices, they cannot provide the services needed to prevent illness, support patients in their homes and provide care closer to home. “Proper general practice investment will fix the NHS and improve care for patients.” Support the work of DAUK by becoming a member or donating to our Go Fund Me. Read Mr Streeting’s speech in full.