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Reaction to Miliband: “We need a meaningful plan”

Dr Chaand Nagpaul, Chair of the BMA’s GP Committee

“GPs care immensely about our patients, and feel dismayed by the constraints impacting on services and undermining our ability to do the best for them.

“The GP service is under unprecedented strain, and is unable to meet the needs of a growing ageing population and the increasing volume of care moving out of hospitals. GPs are working beyond their capacity, seeing a record 340 million patients every year, up by 40 million compared to 2008. Demand on GP services has far outstripped supply.

“A commitment of more GPs will be vital towards meeting the demands on general practice. However we must first address the challenge of getting more doctors to choose to become GPs at a time of falling recruitment and increasing numbers retiring early.

“The figures speak for themselves. A fall of 15% in the number of doctors training as GPs last year, and 451 training places unfilled. We need to address the root causes of this if there is to be any prospect of increasing GP numbers.

“We are already working with NHS England on the best way to create the right environment to make general practice an attractive and rewarding career and whoever is in government next year needs to make this a priority.

“With the NHS facing a perfect storm of rising demand and a £30bn funding shortfall, patients and the public need to see a detailed, meaningful plan from politicians on how they will create a sustainable infrastructure and capacity in general practice to deliver on current and future needs.”

NHS Confederation chief executive Rob Webster

“We will wait for the whole image to emerge when Labour set out their spending plans. It is vital, for example that investment in health services is matched with a settlement in social care that allows a similar, much needed transformation.

“This early and clear commitment is a sign that politicians have taken on board calls to address the challenges facing the NHS and social care. In the 2015 Challenge Manifesto, published earlier this month, the most influential coalition of health and care bodies called for adequate funding for the NHS so that services could be transformed to better meet 21st century needs. More of the same is not an option. So, we asked for longer term funding and a transition fund of at least £4 billion in new money spread over two years. Today’s announcement overlaps with these asks and begins a process by which we can engage in a real debate about the future of health and care.

“The very nature of health service delivery means that most NHS spending goes on staff costs – on nurses, GPs, speech therapists, midwives, oncologists, porters, cleaners and all the other professions that make up the NHS team. So it is right that money for service transformation is targeted at ensuring we have more staff with the right skills working in the right places. Often this is in the community, and includes GPs, community-based nurses, mental health specialists, and staff who can help people live more healthily, for longer, in their own homes.

“Linking transformation to staffing needs to be done in ways that will support local models and the numbers announced today should reflect local plans rather than a top-down allocation of posts.

“No matter how big the pot, a transition fund alone cannot and will not deliver the extent of change needed to tackle the challenges facing the NHS and social care. We need the next government to commit to making much faster progress towards implementing new payment mechanisms that support integrated, personalised care and reward good outcomes for patients, not just activity. And we need the stability which a 10-year funding settlement for health would offer, creating a framework for the kind of change which NHS leaders are chomping at the bit to deliver for patients and local communities.

“What we are missing, however, is a firm commitment from all political parties to ensure none of their proposals will impose yet another top-down structural re-organisation. It is vital that the health service has the stability to implement service changes that reflect local people’s needs and wishes, and take account of the local landscape.

“We have been very clear that the time for action is now. Ed Miliband has today made a powerful speech, which contains much promise. Once the applause from conference delegates has faded, it is vital that he and other politicians move swiftly from words to deeds.”

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