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So long and thanks for all the fish…

Hard-wired GP

Luke Koupparis

Wednesday, 11 July 2018

675px-Official_portrait_of_Mr_Jeremy_Hunt_crop_2.jpgSo, we all thought that Mr Hunt would move on during the last cabinet reshuffle but he refused to budge and pleaded with his boss to stay and finish the job. He even took on additional responsibilities with social care being added to his job title.

However, now he has jumped from health and social care presumably as he sees the Foreign Office as a step in the right direction for his career development. A belated 70th birthday present for the NHS possibly.

What legacy does he leave apart from being the longest running health secretary ever?

Well, he has left the NHS in a much more fragile state than when he took the job on and has lost the goodwill of many staff working at the coalface. He was not afraid of conflict and managed to dig his heels in despite much anger using patient safety and a world class NHS as his mantra. Public opinion and an underlying political motivation to tow the line of the conservative party may have been why he chose to doggedly push through some reforms.

He was famously quoted as saying that his post as health secretary is likely to be his last big job in politics, and history will judge him on his ability to deliver a seven-day NHS. He pursued the requirement for a day routine service and even challenged the evidence presented to him and even after his own officials doubted this evidence.

General practice faced his determination for routine seven day 8am to 8pm working as part of the Improved Access contract. This formed part of the GP Forward View published in April 2016. Refreshed planning guidance published in February 2018, now requires CCGs to provide extended access to GP services, including at evenings and weekends, for 100% of their population by 1 October 2018. Many GPs remain concerned that this is not improved access, but simply spreading scarce resources more thinly. Recent analysis in the BJGP has shown GP interpersonal quality of care was most strongly associated with overall experience over satisfaction with opening hours. However, Mr Hunt continued to ignore the evidence and the improved access is set to become part of most areas in some form.

He has committed to increase GP numbers by 5,000 by 2020 as part of the same Forward View but it seems that this target will be missed and, in all likelihood, we will be faced with fewer numbers. A BMA survey from 2017 demonstrated that nearly half of GPs are planning on quitting medicine in the next five years, a statistic that shows the level of low morale present in the profession at present. Further evidence that his legacy as health secretary leaves much to be desired.

However, he has recently made a case for greater levels of funding to be given to the NHS. Apparently, he was at loggerheads with the treasury on how much more funding should be given with Hunt pushing for a rise of at least 5.2 billion. With the prime minister committing a new long term funding deal of 3.4%, maybe Hunt can feel that this should be part of his legacy in the health top job.

The NHS now has a new fresh face, Matt Hancock, in the top job. A minister first elected in 2010 in his West Suffolk constituency moving from digital, culture and sport secretary, a post he took in January 2018. He knows little about health having a background as an economist at the Bank of England. Let’s hope that he doesn’t use his banking skills to claw back the money promised before it has even hit the NHS.

Picture credit: UK Parliament (CC BY 3.0)

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Luke Koupparis

Luke is a general practitioner in the Bristol area with interests in men's health, child health, minor surgery, online education and medical information technology. He is the IT lead for Bristol clinical commissioning group, LMC representative and chair of the locality provider group. He also works as the medical editor to OnMedica helping to deliver high quality, peer reviewed information to the wider medical community. In his spare time he is a keen road cyclist and likes to ski with his children.
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