GP Funding – Is there a Solution?

What is really going on between the GPs and our Health Minister?

For GPs to pass a motion of no-confidence in our Health Minister last weekend is unusual, for them to talk of investigating a future outside the NHS is even more dramatic. (See UUP response here: https://www.uup.org/gp_conference_decision_was_reckless_and_ill_judged )

Perhaps, more important is something of which we have all become aware – the current process for getting an appointment with a GP simply does not work.

Most of us have experienced trying to get through to a GP first thing in the morning, dialling and redialling and often not getting through to make an appointment before ‘todays safe capacity has been met’. We know that GP appointments have to be rationed out, there is not sufficient capacity to meet demand, but is the random chance of who gets through on the telephone first, the best way to ration GP appointments? Other questions come to mind:

Can we reduce demand for appointments – would charging a fee for each adult appointment reduce demand? Would it be fairer if people on benefits could reclaim this money? Would it be the start of a slippery slope to privatisation?
Or can we increase the appointments available – by funding more GPs
Are we spending our NHS Budget appropriately, would spending more on GPs help.

Percentage Spent on GPs

We are often told that we spend more on our NHS in N. Ireland per patient (£3,236) than England (£3064). (Such comparisons are not easy to make because our NHS integrates Social Service whereas in England the Social Service are paid for by local councils but the figures provided have been adapted to take this into account.)

So why are health outcomes so poor here, are we spending our budget appropriately?

GPs will tell you that the percentage of our NHS budget spent on GP services is too low.

In N. Ireland we spend 5.4% of our NHS budget on GPs, but in England they spend 6.75% on GPs – 1.35% difference).

We spend more money on secondary care – hospitals etc. Is this the best way to allocate the money?

GPs will argue that getting GPs to deal with chronic (long-term or repeat) conditions is cheaper than allowing such patients to occupy hospital beds, but in NI we are more likely to use hospitals and have longer than average hospital stays. Hence, better funding for GPs could be a route to reducing overall costs.

Local Change is Needed

The NHS in Northern Ireland is performing poorly in comparison to the NHS in England or the Irish HSE.

Despite spending £172 more per person in N. Ireland our outcomes are worse. We are twice as likely to be on a waiting list and 30 times more likely to have to wait over a year for surgery than a resident in England.

Despite this some of the reporting at the start of the week seemed focused on trivialities, such as criticising the GPs for holding their conference in an expensive hotel, or making the point that the NHS is British and damning comparisons with the Irish Republic without proper consideration.

If Stormont cannot fix our local NHS, is Stormont worth preserving?