Government Response to the House of Commons Health Select Committee Report on Primary Care (Fourth Report of Session 2015-16) Oct 2016
Anyone hoping that the Health Select Committee under its exGP chairman would throw a spanner into government health policy is in for a disappointment reading this document which the government has welcomed. The introduction pays the customary lip service to "...general practice, one of the great strengths of the NHS" and admits that funding has not kept pace with the increasing demands made upon it. Mostly though the committee applauds government policy and in some areas, such as making sure all practitioners have access to a unified medical record, support for Consultant Connect and a larger proportion of NHS spending for primary care, this is not controversial. But collaboration reaches its apogee in the strong support for the CQC the committee demonstrates and its total rejection of the BMA and RCGP calls to scrap the inspection regime. They do, however, hope that bureaucracy and unnecessary duplication can be reduced, which is good of them. There is then little challenge to any of the DH plans for primary care apart from a call to properly evaluate pilots of seven day a week services (which are enthusiastically supported for those who "cannot" attend routine appointments) and to get proper evidence on which to base future policy. There are some interesting nuggets however. We learn that the questions in the GP Patient Survey will be reviewed to take into account "the changing landscape and provision in general practice and to capture patient views on these areas." Ten minute appointments are condemned as inadequate and the government replies that population health models implemented by the vanguards are the answer. The new voluntary MCP contract supporting integrated primary care and community health services, expected in July, is now promised for December. The committee still seems to be worried about conflicts of interest in commissioning suggesting it is behind the curve in understanding the parlous state of the NHS. The return of qualified professionals to primary care is going well with returners from overseas now being able to start the process whilst they are still abroad and there will be a single point of access to support "...navigating any regulatory issues..." For someone who went to medical school when A levels at grade C were accepted it is interesting that the committee encourages medical schools to look beyond academic achievement and to those "...who can demonstrate a commitment to providing care within their own community." Your correspondent remains confused about what this could mean despite reading that HEE and NHS employers are helping to embed "Values Based Recruitment" in universities. The committee notes the £20,000 bursaries available to encourage recruitment in some areas but want them monitored for value for money and ask the government to look into helping newly qualified GPs and nurses in primary care with their student loan repayments. The government makes no such commitment but will look at further measures "as appropriate." They will however introduce changes to funding to reflect the true cost of training "as early as is possible." The government is committed to develop statutory regulation for physician associates, perhaps learning from the experience of HCAs?
Finally the committee is convinced that only new models of care can ensure the long term sustainability of the NHS. The government stresses how important pharmacists, for example, will be in the future so that GPs can focus on complex conditions, helping them to manage demand and increase access for patients seven days a week. A golden prospect indeed.