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IGPM urges Labour to reconsider its ‘disappointing’ stand on general practice

by Beth Gault
18 January 2023

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The Institute of General Practice Management (IGPM) has urged the Labour party to change its stance on general practice, after it revealed its intention to overhaul the partnership model and allow patients to self-refer to secondary care.

Last week, the shadow health secretary Wes Streeting told the Times he wanted to ‘tear up’ the GP contract and was considering abolishing the GP partnership model and moving to a fully salaried service if the party won the next election. He also said Labour had plans to allow patients to self-refer to secondary care.

This weekend, Labour leader Sir Keir Starmer added he wanted to be ‘ruthless with the bureaucratic nonsense you encounter every day in the health service’ in a piece published by the Telegraph. He also reiterated the intention for patients to self-refer to secondary care without needing a referral from a GP.

In a letter to Sir Keir Starmer and Wes Streeting on 16 January, the IGPM said it was ‘bitterly disappointed’ with the policies.

It said: ‘Your suggestion of a fully salaried model is not something we support. We have seen it fail multiples times.

‘We fear that this will only encourage staff to work-to-rule, and we can speak from first-hand experience on how much of our service is run on goodwill.’

It added that GP partners undertake a lot of extra work and stay ‘well beyond’ core hours to do so. Though many salaried GPs do the same, the IGPM said they have the right to work contracted hours and for contracted activity.

‘If you only have salaried GPs working, there is a risk that there will be a whole collection of work not undertaken because it is not covered within the employment contract,’ the body warned. 

The letter also asked Labour to consider if the government had the infrastructure in place to absorb the back-office functions of thousands of surgeries, and the money to buy premises off partners who own them.

On self-referring to secondary care, the IGPM said it would not be ‘practical’, as GPs need to differentiate which specialist is needed, confirm the urgency of the problem and navigate referral pathways to ensure patients are picked up by the right part of the system.

‘Transferring this work over to hospitals will only lengthen waiting lists as clinicians are lost to triaging referrals instead of providing clinical interventions,’ said IGPM.

‘There is much evidence that patients would self-refer for many innocent symptoms which can be resolved in general practice, which would then further clog the secondary care system with wholly inappropriate requests. Or in the worst case, delay treatment to patients who would otherwise be fast-tracked on a 2-week-wait pathway.’

The body said it would be more than happy to speak to Labour about the issues and invited Sir Keir and Mr Streeting to visit a practice to see first-hand the pressures general practice is currently facing.

In response to the letter, the office of Sir Keir thanked IGPM for writing and said: ‘Please be assured that we are consulting widely on our changes to maintain the future of GP services and the shadow health secretary will take on your views.’

Last week the health secretary revealed the CQC would now only inspect GP practices where there is ‘risk of harm’ to people using the services, in order to help tackle increased pressures in the NHS.