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GPs’ goodwill and resilience propping up NI general practice

Northern Ireland general practice spend lowest in UK, and fewer GPs per head than in the 1950s

Louise Prime

Tuesday, 07 November 2017

GPs’ professional values, goodwill and resilience are all that is maintaining general practice in Northern Ireland as the country lives with its current “political vacuum”, GP leaders have warned. They called on members of Northern Ireland’s legislative assembly (MLAs) to act urgently before they find that their own number exceeds that of doctors in general practice, insisting that “the crisis in our health service is now beyond politics”.

Dr Tom Black, chair of BMA Northern Ireland’s general practitioners committee (NIGPC) told delegates at the Autumn Conference of Local Medical Committees (NI) in Belfast this weekend that with lower per capita funding than the rest of the UK, and fewer GPs per head than there were six decades ago, general practice in Northern Ireland is in crisis.

Dr Black pointed out: “We had a plan this time last year – the GP-led care review plan – and it was signed off by the (Health) minister at the time Michelle O’Neill on 23 December 2017. It hasn’t been implemented because there is no budget, no Health minister and no Assembly.

“We have fewer GPs per-head of the population than we had in the 1950s and we now have more than 2,000 patients per WTE [whole time equivalent] GP in Northern Ireland. We have the lowest funding of all four [UK] countries. If we were given a 50% uplift to GP funding over the next three years we would still lag behind England by 10%.”

He also argued that the growth in administration is having a serious impact on the amount of time that GPs are able to spend with their patients. He said: “Workload in terms of consultations has actually decreased by 500,000 over the last two years because of the workforce crisis. Other work such as prescriptions, blood tests and paperwork continues to increase.”

He warned: “Young doctors are reluctant to take up a career in general practice as they feel that the job is no longer doable.”

Dr Black told delegates that GPs are working hard to address the crisis themselves, and praised them for bringing “innovations into traditional general practice” – for example the development of federations, in-practice pharmacists, doctor first triage and workload optimisation.

He added: “The system needs transformation and GPs have prepared their service better than any other part of the NHS in Northern Ireland to be ready for change.

“In the interim, while we wait for decisions already taken to be implemented, GP practices need to protect their core services for their most vulnerable patients. We can expect no help in the short term and we need to recognise that this crisis and its management is in our own hands. This is our problem and we need to own it.”

The chair of the Annual Conference of Local Medical Committees (NI), Dr Frances O’Hagan, warned: “The crisis in our health service is now beyond politics. We need our politicians to act now to save general practice before we have a situation that sees us have more MLAs than we do GPs.”

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