The BMJ Today: Stop reviewing GP crisis and plan a solution

Two articles just posted on focus on general practice—the crisis that is engulfing it, how it suffers at the hand of political promises, and what action can preserve its future.

Veronica Wilkie, professor of primary care at the Institute of Health and Society at Worcester University, compares the current crisis to that in 1950 when JS Collings, an Australian researcher who had observed 55 practices, attacked general practice for being outdated, rarely satisfactory, and a potential danger to public health.

Two recent reviews concluded something that most GPs don’t need to be told: that there are too few GPs in the UK to meet patient demands. But Wilkie makes a pertinent observation: “That students and trainees who witness stressed, burnt out GPs, who feel isolated and unsupported, are unlikely to choose general practice.”

Wilkies calls for an end to reports on the current problem. What is needed is “a coherent plan for workforce development in primary care,” which is based on a robust analysis of modern day general practice activity.

Stephen Gillam, a GP in Luton, reviews the many strategies that have attempted to ease the pressure on primary care. He blames the dissatisfaction in the profession on a lack of government understanding of GPs’ workload that can’t be filed simply under acute or chronic or immediate or long term conditions. He pleads for understanding on both sides: for GPs to continue to adapt and innovate, and for politicians to listen to experts, “avoid populist gimmickry,” and to increase workforce numbers.

New developments at the National Institute for Health and Care Excellence (NICE)—the UK’s independent body for deciding on what drugs should be funded by the NHS—have raised concerns in some. Deborah Cohen reports that a new minister has been given responsibility for the organisation and his remit is to accelerate innovation. His post falls under the departments of business and health, and the worry is that industry interests will have undue influence on NICE’s decisions, increasing costs for the NHS without proven benefit for patients. It’s something to watch.

Zosia Kmietowicz is assistant news editor at The BMJ.