Dr Welch warned that GPs cannot continue to act as a ‘last resort’ for services that have not been properly commissioned elsewhere in the NHS.

She was speaking in her role as vice chair of North Cumbria Local Medical Committee and quoted in the News and Star.

Dr Welch, a GP in Carlisle, said that the withdrawal of GP-provided phlebotomy in Cumbria has exposed how far practices have stretched beyond their core contract to protect patients. She said they often absorbed hospital work without funding or infrastructure.

Last resort

She said: “Some GP practices have continued to absorb this work which obviously sends mixed messages that GPs can do this – but it is unsustainable and is plugging commissioning gaps that should be adequately resourced by the ICB.

“GPs can not be the last resort and feel pressured to take on the work of other services just because the service has not been adequately commissioned, but often we are, because otherwise what will patients do?”

Read the News and Star article in full.

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The letter follows Health Secretary’s recent decision to release text messages exchanged with Peter Mandelson.

Signatories to the letter, including DAUK, welcomed that disclosure but argued that the same standard should apply to discussions with donors who may benefit from government health policy.

The letter highlights concerns about the scale and source of donations received by the Health Secretary.

Private health donors

An investigation in April 2025 by the Good Law Project, cited in the letter, reported that Mr Streeting received donations from private health companies or individuals with interests in private healthcare at a rate of £10,000 per month.

The letter says that up to 60% of donations to Mr Streeting since 2015, totalling around £372,000, came from these sources.

The signatories are asking Mr Streeting to release messages relating to health policy, Department of Health and Social Care announcements, and NHS contracts exchanged with five named donors, including executives and investors linked to healthcare recruitment, private providers and US health insurance firms.

Public trust

The letter says the publication of these communications would help to reassure the public that current reforms, including expanding the use of private providers in delivering NHS services, are not influenced by undisclosed ‘quid pro quo’ relationships.

Co-chair Dr Ellen Welch, who has signed the letter on behalf of DAUK, said: “Transparency is fundamental to public trust in our politicians and the motivations for their decisions.

“When senior decision-makers receive funding from individuals and companies that stand to gain from health policy, it is entirely reasonable to ask for openness about those relationships.”

The signatories have also requested a meeting with the Health Secretary to discuss their concerns.

Transparency

Johnbosco Nwogbo, campaign lead at We Own It said: “We can disagree in good faith on the correctness or wrongness of any particular health policy, but voters need to know that private sector parties are not clandestinely influencing what ends up being decided.

“This is an opportunity for Wes Streeting to raise the bar on transparency in public service.”

Read the open letter in full below.

Dear Rt Hon. Wes Streeting MP,

Thank you for publishing your WhatsApp messages with Lord Mandelson in order to be transparent about the nature of your relationship. This step was particularly important because his lobbying firm, Global Counsel, has worked for Palantir and other firms that have a direct interest in government policy, including policy affecting the health service, which he was likely influencing.

We the undersigned are writing to ask you to extend this important step toward transparency to persons who have donated to you and with whom you have discussed health policy, DHSC announcements and NHS contracts.

With 60% of your donations coming either from the private healthcare sector, or from individuals with a financial interest in the private healthcare sector, you can demonstrate that your NHS reforms are driven by principle, rather than unaccountable lobbying.

In April 2025, the Good Law Project revealed that you received donations from private health companies or individuals with interests in private healthcare at a rate of £10,000 per month. Up to 60% of your donations since 2015, totalling £372,000, came from these sources.

We are therefore asking you to release your messages with the following persons:

• Peter Hearn, whose healthcare workers’ recruitment firms MPM Connect and OPD Group have given you a total of £197,900. He has also given you £40,000 in his personal capacity;
• John Armitage, a hedge fund manager with investments of half a billion dollars in United Health, the US’s largest health insurance company, has given you £95,000;
• Sir Trevor Chinn, a senior advisor to a firm holding investments in several private health companies, gave you £18,500;
• Kevin Craig, founder and CEO of PLMR a political consultancy that advises a firm that provides temporary staff to the NHS, has given you £13,000, and
• Red Capital Ltd, controlled by a sitting director of Europa Healthcare Group, Lord Jonathan Mendelsohn, has given you £5,000.

Releasing to the public your messages with these donors (relating to health policy, DHSC announcements and NHS contracts) would help assure the public that your policy of increasing the use of the private sector for the provision of NHS services, is not driven by a quid pro quo relationship.

We would be also grateful for an opportunity to meet with you to discuss this matter further.

We look forward to hearing back from you soon.

Kind regards

Dr Ellen Welch – co-chair, Doctors Association UK

Cat Hobbs – director, We Own It

Linda Burnip – Disabled People Against Cuts

John Puntis – co-chair, Keep Our NHS Public

Mark Ladbrooke – chair, Socialist Health Association

Jan Shortt – general secretary, National Pensioners Convention

Dr Julia Grace Patterson – director, Every Doctor

Diarmaid McDonald – director, Just Treatment

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.

The article is titled Why doctors are uniquely vulnerable to domestic abuse.

It features Dr Ellen Welch, DAUK co-chair, and Dr Sarah Jacques, DAUK GP co-lead, and their work highlighting the ‘silent pandemic’ facing NHS workers.

NHS Domestic Abuse Awareness Day

Dr Welch and Dr Jacques are also campaigns co-leads for the Medical Women’s Federation. They are co-ordinators of NHS Domestic Abuse Awareness Day, which took place for the first time in December.

The article includes the real-life stories of NHS workers who have experienced abusive relationships. It also highlights the research and work being done on the issue.

Read the article in full in this week’s BMJ or on the BMJ website.

Find out more about NHS Domestic Abuse Awareness Day

DAUK committee members are all volunteers. They campaign and speak in the media about issues facing doctors in their own time. Please support our work by joining DAUK or donating to our GoFundMe.

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”]

National Emergency Briefing

Dr Lee and co-chairs Dr Helen Fernandes and Dr Ellen Welch represented DAUK at the briefing. Hundreds of MPs, Peers, and leaders from business, faith, sport, and culture also attended Ten of the UK’s leading experts on the climate and nature crisis delivered the briefing. The the audience with the latest implications for health, food, national security, and the economy. The experts emphasised the threats were no longer distant projections but rapidly accelerating realities that will profoundly affect public health. Dr Lee is the driving force behind Our Health, Our Planet.

Our Health, Our Planet

The website brings together hundreds of resources with the aim of raising greater awareness of the threat of climate change to people’s health and steps they can take to minimise it. Dr Lee said: “Tackling climate change must be the number one health priority for the government. “Doctors and healthcare professionals are already seeing the health impacts of the climate crisis, from heat-related illness to respiratory disease caused by poor air quality. “The public needs to understand the scale of the risks we face and the solutions available, which is why we’re supporting this call for an urgent televised national emergency briefing. “It needs to be backed up by a comprehensive public engagement campaign.

Climate change

“Clear and accurate communication is critical. People need to understand the risks, but also the steps we can take to tackle climate change and to protect health.” Dr Lee is the driving force behind Our Health, Our Planet. The website brings together hundreds of resources with the aim of raising greater awareness of the threat of climate change to people’s health and steps they can take to minimise it. The letter urges the Government and broadcasters to deliver a national emergency briefing and launch a comprehensive public engagement campaign. It concluded: “If delivered urgently and truthfully, with ambition matching the scale of the crisis, this will not only ensure that the public is properly informed but will also offer the protection that knowledge and preparedness bring.

Public engagement campaign

“Such a campaign will resonate with the public, opening up the political space for the action needed. “We are not safe. This is an emergency. Now is the time for courage and to put trust in the public. The UK has a track record of uniting to face difficult challenges. Now is the time to do this again.” Click here to read and sign the letter. DAUK committee members are volunteers and campaign about issues facing doctors in their own time. Please support our work by joining DAUK or donating to our GoFundMe.

Despite clear signs of a rapidly spreading global pandemic, which NHS staff watched with horror as the world locked down, the UK death toll was rising with no restrictions in place.

Contact tracing was abandoned in early March 2020, and large gatherings continued to take place up until the end of that same month.

The Covid Inquiry report reveals that if the government had introduced the first lockdown a week earlier, 23,000 people in England alone would not have died.

DAUK’s Protect the Frontline campaign, collaborating with Led by Donkeys called for adequate PPE for NHS staff.

PPE supply

Thousands of doctors signed up to our NHSPPE app giving daily reports on the PPE supply they had access to. We also raised our concerns that staff were being discouraged from speaking up about PPE in the press.

Dr Ellen Welch, DAUK co-chair and author of How the NHS coped with Covid-19, said: “Frontline staff were left woefully unprotected by a lack of PPE, and DAUK provided a voice for doctors to speak up about this when many felt gagged by their trusts.

“We all saw colleagues don homemade PPE to go to care for patients and two months later nearly 300 healthcare workers had died.

“DAUK welcomes the recommendations of the inquiry and hopes lessons have been learned around the key theme of preparedness.

“Future pandemics will come and it would be an insult to those who lost their lives, or continue to live with long Covid, if we did not.”

Covid Airborne Transmission Alliance

DAUK is a member of the Covid-19 Airborne Transmission Alliance (CATA), which gave testimony as part of the inquiry about how UK healthcare officials systemically denied overwhelming scientific evidence that Covid-19 was airborne.

Watch CATA chair Dr Barry Jones giving evidence here.

Dr David Nicholl, consultant neurologist and DAUK committee member, said: “I was thinking how much of a media hullabaloo there was, rightly, over the Iraq War when there were 179 UK deaths, yet how quickly there has been a concerted action to move along from the pandemic by the media.

“There were more than 200,000 deaths from Covid, including hundreds of healthcare workers. Some like Boris Johnson clearly don’t want to learn.”

Dr Welch added: “As another winter takes hold, NHS staff approach it this year without the protection of the covid vaccine.

Covid Inquiry report

“The Covid-19 Inquiry report should serve as a reminder to those in power of the damage wielded by this virus, and urge them to start implementing measures now to protect staff and patients, such as vaccinations, masks, ventilation to name a simple few.

“Politicians may want to forgot this saga, but NHS staff never will.”

Dr Alison George, a GP and member of the DAUK GP committee, said: “NHS staff have been totally excluded from the vaccination programme and the cost to purchase one privately ranges from £95 to £99.

“There is no clear explanation for such an irresponsible and short-sighted decision.

Long Covid

“Added to the physical effects on individual staff of acute and long Covid, it is likely to lead to increased staff sickness, cancellation of procedures and treatments and higher rates of nosocomial Covid.

“It is also worth considering the impact of the message this sends to staff and the public about the need for any mitigations against Covid.”

DAUK committee members are volunteers and campaign about issues facing doctors in their own time. Please support our work by joining DAUK or donating to our GoFundMe.

England LMC Conference

He was speaking after the England LMC Conference, which was held in Manchester on Friday. Dr Taylor attended on behalf of DAUK with our co-chair Dr Ellen Welch. Dr Taylor said: “It is clear from the England LMC Conference that GPs are extremely unhappy with the current position of the Government towards general practice. “The imposition of contracts, a failure to fund practices adequately to provide safe, timely care for patients, and continued briefings in the media against GPs have resulted in clear mandates.

Listen to GPs

“The Government must listen to general practice in delivering care in the community. Failure to do so will result in worse care for patients. “All motions were about patient care and the needs of patients for access to GPs. “More funding means more GPs, appointments, future capacity, and better outcomes in terms of prevention and costs to the public being less. “The Government needs to invest to save.” DAUK committee members are all volunteers and campaign about issues facing doctors in their own time. Please support our work by joining DAUK or donating to our GoFundMe.

Irresponsible and short-sighted

The committee said: “The decision to deny healthcare workers a free Covid vaccine this year is irresponsible and extremely short-sighted. “Healthcare workers are offered flu vaccines every year because we are at high risk of exposure to flu and to spreading it, so why are we now excluded from Covid vaccination, other than to save money in the very short term? “It will lead to increased staff sickness and put healthcare workers at risk of acute and long Covid. “It will also lead to higher rates of hospital-acquired Covid, cancelled operations and procedures impacting NHS capacity – all of which is likely to make the decision more expensive in the long run.

Covid vaccination

“As Covid is surging again, some NHS trusts have brought back mask mandates, yet we are expected to pay for vaccination ourselves at some expense. “The Government’s advice on vaccination states an ‘example price’ for a Covid vaccine of £25, but the cost of a private jab is between £75 and £99. “If the cost doesn’t put healthcare workers off getting one, then companies will be profiteering from the Government’s decision. “We would be very interested to know on what advice the decision was made.” The statement has been used by Doctors.Net.UK,

Short memories

Meanwhile DAUK co-chair Dr Ellen Welch, a GP based in Cumbria, has written on the issue on the DAUK Substack. She said: “We have very short memories when it comes to the Covid pandemic. We don’t want to remember, and understandably so. “But when it comes to minimising the damage of new Covid waves, and indeed any new diseases that come along in the future, we need to look at what did make a difference and implement that within our organisations.” Read Dr Welch’s Substack post in full. DAUK committee members are all volunteers and campaign about issues facing doctors in their own time. Please support our work by joining DAUK or donating to our GoFundMe.

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.

Mounjaro

It found that fewer than half of England has access to Mounjaro through general practices. Some 18 of 42 commissioning bodies across the country confirmed they had started prescribing tirzepatide in line with NHS England’s primary care roll-out plan. And that nine ICBs confirmed they had been allocated enough NHS funding to cover at least 70% of their eligible patients. Dr Welch said: “These figures confirm the fear that the roll-out is not fit for purpose. There is a huge discrepancy between national messaging and what patients are actually being delivered on a local level.

Weight-loss treatment

“As a GP I get several queries a week from patients asking for GLP-1 RAs [glucagon-like peptide-1 receptor agonists] to be prescribed for weight loss, and very few meet the strict NHS prescribing criteria.” The manufacturer of Mounjaro, Eli Lilly, has said it will increase the price of the drug by as much as 170%. Dr Welch told the BMJ this was ‘sure to lead many more patients to the door of their GP surgeries, where they will sadly be met with an inadequate service, even if they do meet the narrow criteria’. Her comments have been widely reported including by Sky News , The Guardian, The Sun, The Mirror, and The Independent. DAUK committee members are all volunteers and speak to the media about issues facing frontline doctors in their own time. Please support our work by joining DAUK or donating to our GoFundMe.