Dr Steve Taylor, DAUK GP spokesperson

The budget has failed to address the crisis in general practice and provide the funding needed for safe and effective patient care, says the Doctors’ Association UK (DAUK).

Dr Steve Taylor, DAUK GP spokesperson, said Chancellor Jeremy Hunt’s latest budget does nothing to reverse the massive funding cuts to general practice in the past decade.

He said that despite more demand than ever, practices are closing, GPs are leaving and some are without work, describing it as a ‘catastrophe for patients’.

Citing remarks made in 2021 by Mr Hunt, a former Health Secretary, Dr Taylor said the budget ‘won’t turn the tide’ for GPs.

Dr Taylor said: “As representatives of GPs working in the NHS, the budget has failed to provide what is needed for safe and effective patient care in the community.

“Jeremy Hunt said in 2021 of a funding announcement for general practice that ‘as someone who tried and failed to get 5,000 more GPs into the system, I don’t think this package will turn the tide’.

“Well this package won’t turn the tide.

“The failure to mention GPs, many of whom are now struggling to get work due to overall funding cuts of 20% per patient per year since 2016, is hugely disappointing.

“GP employment is a big issue.

“People need access to GPs but the Government has only agreed to give 2% more funding, or £3 per patient per year.

“General practice has been the most productive area of the NHS, with GPs doing 20% more work than in 2019 with fewer GPs. That’s more appointments, more face-to-face, more on the day, more in the week.

“The reward for this extra productivity is a cut in funding.

“Capacity has been reached and yet practices are closing, GPs are leaving the profession and some are without work. 

“This is a catastrophe for patients up and down the country with no help from Government.”

A new book by a former Doctors’ Association UK co-chair that highlights the crisis facing general practice is already a best seller – before it’s even published.

Why Can’t I See My GP? The Past, Present and Future of General Practice by Dr Ellen Welch is due to be published on Thursday 8 February and is already listed as a best seller on Amazon.

Its publisher Calon/University of Wales Press has announced it is already being reprinted, such is the demand. All royalties are being donated to DAUK.

Dr Welch said: “This book is a cumulation of the work done with DAUK since the pandemic, shining a spotlight on the issues within general practice.

“The hope is our leaders will read the experiences of NHS staff, and take positive action to invest in the service.

“Primary care holds the NHS together and when it collapses, we will be left with a private healthcare system that many will be unable to afford.”

DAUK has sent a copy of the book has been sent to all 650 MPs and hopes, with 2024 an election year and the NHS a priority to the public, it will put general practice at the top of every manifesto.

The book walks us through the state of general practice with passionate testimony from GPs who live and breathe the NHS.

Why Can’t I See My GP?  outlines what the problems are, why we have reached this point, and offers some workable solutions.

It is full of personal accounts from GP leaders including Dr David Wrigley, the deputy chair of the BMA GP committee; Dr Lizzie Toberty, GP lead for DAUK; and Dr Paul Evans, GP and chair of Gateshead and North Tyneside LMC.

Other contributors include health writer Ellie Philpotts, broadcaster and commentator Roy Lilley, and Chris Milligan, the husband of GP Dr Gail Milligan, who took her own life in 2022, and Dr Aman Amir, a Merseyside GP whose surgery was subject to an arson attack.

Dr Katie Bramall-Stainer, chair of the British Medical Association’s England GP committee, said: “This is essential reading for any of us who may want to justifiably know why the jewel in the heart of the NHS crown may be lost forever.

“As the saying goes, ‘you don’t know what you’ve got ’til it’s gone’. Thankfully Ellen Welch presents us with elegant solutions.”

Dr Matt Kneale, co-chair of DAUK, said: “This book is essential reading for anyone who values the ethos of a universal healthcare system and the indispensable role of a family doctor.

“It beckons public awareness and action at a time when it’s most needed.”

Dr Phil Whitaker, GP and author of What Is a Doctor?, added: “The passion for delivering high quality medical care shines out from each contribution to this unique book, and is matched only by the perplexity at the disintegration of what has long been the jewel in the NHS’s crown – British general practice.

“If it is to be restored, some of the solutions will be found within these pages.”

Polly Morland, author of A Fortunate Woman, said: “A book that combines clear-sighted pragmatism with a keen and compassionate ear for the GP experience on the ground.

“A valuable contribution to an urgent debate.

“I hope the book finds many readers both within and beyond the medical profession — above all, among healthcare policymakers. Let’s hope they’re listening.”

Why Can’t I See My GP? by Dr Welch is published by Calon/University of Wales Press on 8 February.

Dr Lizzie Toberty, DAUK’s GP Lead, said a 1.9 per cent rise would be “completely derisory” and was well below the level of inflation.

She was responding to a report in PulseToday.co.uk that the Government’s initial offer for this year’s GP contract includes only a 1.9 per cent rise in baseline funding, at a time when other parts of the health service have received funding uplifts of six per cent.

Dr Toberty said: “A 1.9 per cent uplift is completely derisory and is yet another reduction in payments in real terms.

“We can’t possibly continue to run general practice on contract uplifts that are hugely below inflation. Our costs are astronomical and have been going up and up while we’ve had to endure cuts and freezes to our funding.

“It is clear this Government has absolutely no commitment to primary care.

“It’s becoming an increasing struggle for people to access the basics of general practice care.

“We now find out that Additional Roles Reimbursement Scheme (ARRS) staff have not reduced workloads due to a lack of skills.

“And we’re also seeing a huge amount of money being diverted to the Pharmacy First scheme.

“None of this would have been needed if the money for primary care had been spent on doctors and  nurses in the first place.

“We urge them to fund general practice appropriately. An extra £30 to £50 per patient per year would be transformational and mean we can do our job of supporting the nation’s health properly. 

“£200 per PT per year, would still represent phenomenal value.

“There is a very real possibility that if the government does not increase funding we are heading towards a dentistry model of private care being all that is available in many areas. This would be an unmitigated disaster.”

DAUK spokesperson and GP Dr Steve Taylor said: “The 1.9 per cent represents a real terms cut for GP practices who have seen a 20 per cent real terms cut in income since 2016.

“Many practices are unable to pay for core staff including GPs and some are making GPs redundant.

“This is at a time when the country needs GPs.

“The Conservative manifesto in 2015 promised 5,000 more GPs and the 2019 one promised 6,000 more. We now have 2,000 fewer GPs than 2015.

“This contract offer shows what the Government really thinks of GPs and patient care.

“Many GPs, including myself, are extremely angry, but sadly others are just leaving.”

Pulse reported that Katie Bramall-Stainer, chair of the General Practitioners Committee (GPC), has written to primary care minister Andrea Leadsom to ask her to intervene in the negotiation.

In her letter, she said: “It is with genuine regret that I write to you today to seek to markedly improve the current grossly inadequate GMS (general medical services) baseline funding increase offer of 1.9% (£178m).

“By choosing to set aside the compelling body of evidence that GPCE has presented, the starvation of core funding at a practice-level will have devastating consequences on local patient services.”

Dr Lizzie Toberty said the Government should ‘stop dancing around the edges’ and provide proper funding to ease the crisis facing general practice.

Dr Toberty said: “We welcome all the support we can get at this difficult time for general practice.

“However, Pharmacy First will only help with a very small number of people, and we’d be surprised if it had any real impact on improving access to your GP.

“The reality is that we are in dire need of support for patients in our communities with complex conditions who we are doing our best to look after.

“What we need is better funding, better buildings, and better IT infrastructure.

“With proper, sustained investment we’d be able to provide the primary care service that the people of this country expect and deserve.

“We’d encourage the Government to stop dancing around the edges and to improve the absolute minimal funding that primary care is receiving at the moment and is struggling to manage with.

“We can’t provide quality care on a shoestring and need investment now.”

Through the new service, pharmacists will be able to provide advice to patients and issue medicines for seven common conditions in sinusitis; sore throat; earache; infected insect bite; impetigo; shingles and uncomplicated urinary tract infections in women.

Women will also be able to get the contraceptive pill from pharmacies without the need for a GP appointment.

Dr Steve Taylor, a GP based in Manchester and DAUK spokesperson, said the new Pharmacy First service highlighted significant disparities in funding between GPs and pharmacists.

Under the new service, pharmacists will be paid £1,000 a month, plus £15 per consultation for providing 30 consultations a month.

Dr Taylor said this equated to £48 per consultation – more than double the £23 per consultation that GPs currently receive.

“Pharmacists will be dealing with relatively minor issues that would take minutes for a GP to sort, but  are being paid more than double per consultation than GPs currently receive,” he said.

“That can’t be right.

“The funding formula for GPs has increased from £153 per head in 2015 to £163 now with no cap on the number of consultations we can do. It’s a big cut in real terms.

“Practices are doing 18 per cent more work in that time, so they’re doing more work and doing it for less.

“It’s making it harder for general practices to be financially viable, which means that GPs can’t afford to employ and recruit members of staff, which effectively reduces capacity, and is even causing some GPs to leave the profession.

“It has to change, and we need the Government to act now.”

The Doctors’ Association UK (DAUK) has sent every Member of Parliament a copy of this powerful new book which focuses on the crisis facing general practice.

With 2024 an election year and the NHS a priority to the public, DAUK hopes Why Can’t I See My GP? The Past, Present and Future of General Practice will put general practice at the top of every manifesto.

Written by Dr Ellen Welch, a GP and past co-chair of the Doctors’ Association UK (DAUK), the  book walks us through the state of general practice with passionate testimony from GPs who live and breathe the NHS.

Why Can’t I See My GP?  outlines what the problems are, why we have reached this point, and offers some workable solutions.

Dr Welch said: “NHS staff are there day in and day out, and see what needs to be done to improve the current crisis, and we need those in power to listen to our stories, to visit local GP surgeries and appreciate the experience and expertise those on the frontline can offer.

“By sending a copy of the book to every MP, we want to speak directly to our policy makers in Westminster and raise the alarm to urge them to listen to the stories and experiences of frontline NHS staff.”

Why Can’t I See My GP?  is full of personal accounts from GP leaders including Dr David Wrigley, the deputy chair of the BMA GP committee; Dr Lizzie Toberty, GP lead for DAUK; and Dr Paul Evans, GP and chair of Gateshead and North Tyneside LMC.

Other contributors include health writer Ellie Philpotts, broadcaster and commentator Roy Lilley, and Chris Milligan, the husband of GP Dr Gail Milligan, who took her own life in 2022, and Dr Aman Amir, a Merseyside GP whose surgery was subject to an arson attack.

If you’ve ever found yourself frustrated by the length of time it takes to get a GP appointment, then Why Can’t I See My GP? is for you.

Dr Katie Bramall-Stainer, chair of the British Medical Association’s England GP committee, said: “At a time when other national health systems are trying to create the British model of general practice this pithy polemic, deliciously served oven-ready in small, easily digestible portions will equip and empower the reader to question why our government is seeking to dismantle ours.

“This is essential reading for any of us who may want to justifiably know why the jewel in the heart of the NHS crown may be lost forever.

“As the saying goes, ‘you don’t know what you’ve got ’til it’s gone’. Thankfully Ellen Welch presents us with elegant solutions.”

Dr Matt Kneale, co-chair of DAUK, said: “Dr Welch delves into the stark reality of why seeing your GP has become a struggle.

“Unveiling the systemic issues within the NHS through the lens of a seasoned GP, it lays bare the concerns many of us have tirelessly voiced.

“It’s not merely about the dwindling availability of GP appointments, it’s about the unravelling fabric of a health service built for all.

“This book is essential reading for anyone who values the ethos of a universal healthcare system and the indispensable role of a family doctor.

“It beckons public awareness and action at a time when it’s most needed.”

Dr Phil Whitaker, GP and author of What Is a Doctor?, added: “The passion for delivering high quality medical care shines out from each contribution to this unique book, and is matched only by the perplexity at the disintegration of what has long been the jewel in the NHS’s crown – British general practice.

“If it is to be restored, some of the solutions will be found within these pages.”

Polly Morland, author of A Fortunate Woman, said: “A book that combines clear-sighted pragmatism with a keen and compassionate ear for the GP experience on the ground.

“A valuable contribution to an urgent debate.

“I hope the book finds many readers both within and beyond the medical profession — above all, among healthcare policymakers. Let’s hope they’re listening.”

Why Can’t I See My GP? by Dr Welch is published by Calon/University of Wales Press on 8 February. All royalties for the book are being donated to DAUK

Frontline GPs lift the lid on the crisis facing general practice in a powerful new book.

Why Can’t I See My GP? The Past, Present and Future of General Practice explores the state of general practice with passionate testimony from GPs who live and breathe the NHS.

Written by Dr Ellen Welch, a GP and past co-chair of the Doctors’ Association UK (DAUK), the  book takes us from the creation of NHS general practice in 1948 to the crises it is experiencing today.

It explores how the job of a GP has changed in that time and what can be done to retain the service and to make it better for us all.

The book features personal accounts from GP leaders including Dr David Wrigley, the deputy chair of the BMA GP committee; Dr Lizzie Toberty, GP lead for DAUK; and Dr Paul Evans, chair of Gateshead and North Tyneside LMC.

Other contributors sharing their experiences include Dr Aman Amir, whose surgery was targeted by arsonists; broadcaster and commentator Roy Lilley, who recalls the dawn of the NHS; and Chris Milligan, the bereaved husband of GP Dr Gail Milligan, who took her own life in 2022.

NHS crisis

Dr Welch said: “It’s a tough, demoralising time to be an NHS GP and things seem to get worse every year rather than better.

“This book emerged on the back of four years of campaigning for better alongside the DAUK – better not only for GPs and their teams, but for patients too because, ultimately, we’re all going to be patients at some point and we need to fight for a functioning system that will be there when we need it. 

“As an election looms, the NHS and general practice in particular needs to be at the heart of every political manifesto.

“This book explains why and we urge anyone with a stake in the NHS – staff, patients, leaders – to take a read.

“If general practice fails, the NHS fails so we need both understanding and investment from our government.”

Dr Katie Bramall-Stainer, chair of the British Medical Association’s England GP committee, said: “At a time when other national health systems are trying to create the British model of general practice this pithy polemic, deliciously served oven-ready in small, easily digestible portions will equip and empower the reader to question why our government is seeking to dismantle ours.

“This is essential reading for any of us who may want to justifiably know why the jewel in the heart of the NHS crown may be lost forever.

“As the saying goes, ‘you don’t know what you’ve got ’til it’s gone’. Thankfully Ellen Welch presents us with elegant solutions.”

Essential reading

Dr Matt Kneale, co-chair of DAUK, said: “Dr Welch delves into the stark reality of why seeing your GP has become a struggle.

“Unveiling the systemic issues within the NHS through the lens of a seasoned GP, it lays bare the concerns many of us have tirelessly voiced.

“It’s not merely about the dwindling availability of GP appointments, it’s about the unravelling fabric of a health service built for all.

“This book is essential reading for anyone who values the ethos of a universal healthcare system and the indispensable role of a family doctor.

“It beckons public awareness and action at a time when it’s most needed.”

Dr Phil Whitaker, GP and author of What Is a Doctor?, added: “The passion for delivering high quality medical care shines out from each contribution to this unique book, and is matched only by the perplexity at the disintegration of what has long been the jewel in the NHS’s crown – British general practice.

“If it is to be restored, some of the solutions will be found within these pages.”

Why Can’t I See My GP? by Dr Ellen Welch, GP and past DAUK co-chair, is published by Calon/University of Wales Press on 8 February.

All royalties for the book are being donated to the DAUK.

Dr Lizzie Toberty said that, following this week’s rise, people will be paying more for their TV licence fee than the Government pays for general practice.

She added that music festival tickets, phone contracts and even pet insurance all cost more than the per-patient funding the Government puts into primary care.

Dr Toberty said: “The per-patient funding for primary care currently stands at £164 annually, regardless of visit frequency.

“The TV licence fee has just gone up to £169.50, which means that the Government is happy for people to pay more for their TV licence than it is willing to put into GP healthcare.

“Festival tickets, phone contracts and pet insurance all cost more than GP services.

“We’re experiencing a funding and staffing crisis in primary care and that lack of investment over the past decade and a half is the main reason that people struggle to get a GP appointment, and that really matters to people.

“We rightfully have high expectations of what our GPs should be able to do for us and everyone is up in arms when they’re not able to get an appointment,  and yet the Government doesn’t value it and pay for it in a meaningful and significant way.

“If it had kept up with inflation, GP funding should be closer to £197 per patient, which would make a massive difference to the service we provide.

“We have a huge shortage of GPs in the UK and it would really help to address that.

“It’s time for the Government to show it cares about primary care and to invest in it properly to ensure the best service for patients.”

In their letter to ministers and shadow ministers, DAUK’s GP Leads Dr Lizzie Toberty and Dr Steve Taylor said that patient safety was being put at risk by underfunding and staff shortages.

The letter was sent to Health Secretary Victoria Atkins, Primary Care Minister Andrea Leadsom, Shadow Health Secretary Wes Streeting, and Shadow Primary Care Minister Preet Gill.

It called for an increase in core funding for primary care, significant investment in estates and IT, and support for GPs to make “informed local decisions for their communities”.

Their letter said: “The rapid increase in non-doctor staff, the push towards working at scale, and persistent funding cuts have contributed to a rise in missed diagnoses.

“We have prioritised broad access and seeing any available clinician over the well-documented benefits of continuity of care with a GP.

“Continuity of care is known to reduce mortality, reduce the likelihood of hospital admissions, and improve patient satisfaction. If these benefits were replicated by a medication, it would be prescribed universally.

“Yet, the current conditions in primary care are the antithesis of this ideal.”

The letter highlights the fall in funding for primary care from 12% to 8% of the NHS budget.

It said: “The per-patient funding for primary care stands at £164 annually, regardless of visit frequency.

“This amount is comparatively lower than many will spend on phone contracts, festival tickets or pet insurance. Adjusted for inflation, the funding should be closer to £197 per patient.

“The consistent devaluation and defunding of general practice are now manifesting in detrimental outcomes for patients.”

Dr Toberty and Dr Taylor said DAUK stands ready for discussions with the Conservative Government and the Labour Opposition to develop plans “which enable continuity of care at their core”.

Commenting on the letter, Dr Toberty said: “We have a shortage of GPs in the UK and need sustained investment to address that.

“And we need a whole system approach based on continuity of care with a GP – and we need it now to ensure the best levels of service for patients.”

Read the letter in full.

Dr Lizzie Toberty, DAUK’s GP lead, said the UK needed more GPs and quicker access to specialists and scans to improve cancer outcomes.

She was responding to Cancer Research UK’s cancer plan, which aims to prevent 20,000 cancer deaths a year by 2040.

Dr Toberty, a GP in the north east of England, said: “We have had more than a decade of austerity, cuts to services, and underinvestment, and an under-appreciation for the skill set that exists in primary care.

“GPs are constantly getting mixed messages. We’re told we need to reduce referrals and carry more risk in order to prevent hospitals from being overwhelmed, while at the same time being told we’re not doing enough to ensure early diagnosis.

“We currently have a shortage of GPs in the UK and urgently need sustained investment into primary care core funding – starting now – in order to increase their numbers and to create the conditions for patients to know and trust their GP.

“And we need the funding to enable GPs to have quick access to specialists and scans within hospitals.

“We need a whole system approach based on continuity of care with a GP and ease of access to investigations and specialists.

“The UK is no where near where it should be and without the funding and investment the UK will continue to see above average deaths from cancer.”