Posted on 18/10/2017 by
The head of the Royal College of GPs has demanded a promise from Jeremy Hunt, the health secretary, about the status of EU doctors working in the NHS. Professor Helen Stokes-Lampard told iNews that the government’s failure to guarantee EU nationals will still be able to work in the NHS post-Brexit is making it harder to fill GP positions and exacerbating the workforce crisis.
“The big, big issue for general practice is workforce. We’re in a resource-constrained environment where we have too few healthcare professionals in the system as it is,” she said. “
Despite the promises we’ve had for more doctors, actually we need more than ever to protect and preserve the healthcare professionals that we’ve already got. For goodness sake we need a promise, just give us a promise.”
Two years ago, Mr Hunt promised 5,000 more GPs will be working in the NHS in England by 2020. However, the latest figures published by the NHS show that there are about 350 fewer GPs now than there were in 2015.
Around 11% of doctors in the NHS are from the EU
Fears that there could be a mass exodus from the NHS are growing as evidence mounts that EU nationals are already beginning to leave. Some 17,197 EU staff, including nurses and doctors, left last year, compared with 11,222 for 11 months in 2014.
Asked whether a no-deal scenario will make it harder for Mr Hunt to fulfil his promises, Professor Stokes-Lampard said: “Absolutely. If you were a general practitioner in Spain who had been considering [prior to the EU referendum] moving to the UK, you’d be reconsidering your options, wouldn’t you? That’s an inevitable consequence [of Brexit]. People don’t want to take the risk of moving their families and livelihoods if their future is so uncertain. Why come to the UK when they could go to Germany?”
Around 11% of doctors in the NHS are from the EU. The RCGP does not have definite figures for the number of GPs who are from the EU but Professor Stokes-Lampard believes it is “a significant number”.
She said: “We are also concerned about the wider NHS, because if hospitals are under pressure and haven’t got the nurses and doctors they need then that inevitably creates [knock on effects] into general practice, so the whole system is interdependent.
“We’re desperately calling for a promise that all healthcare professionals [from the EU] are given assurances about their ability to stay within the UK post-Brexit, absolutely. It’s a no-brainer and all the Royal Colleges are coming in for that. We want that assured. It can be a unilateral agreement and not part of a bargaining process.
“If we are in a no-deal situation, that doesn’t mean we can’t make promises to those who are helping to shore up the NHS.”
Two in five GPs say they are unlikely to be working in the profession in England in five years
Speaking to iNews at the RCGP’s annual conference in Liverpool, Professor Stokes-Lampard said she was surprised to hear Mr Hunt tell GP delegates in his keynote speech that “decades of under-investment” in primary care meant that the “magic” of seeing a doctor who remembered their patients’ names was now under threat. “I was struck by that,” she said.
“I don’t think I’ve heard him refer to the NHS in those terms before. That was a very big admission and he intended to say it.” Child obesity Doctors should see data on children from the National Child Measurement Programme, which includes details on weight, Professor Helen Stokes-Lampard said.
“Children who are fit and well don’t usually end up at their GP. But they aren’t the front line of preventing childhood obesity. This is education, schools, communities, public health. I do believe GPs should be informed of the results of the weighing programme. Currently, GPs don’t know if a child is classified as obese. The only time we know is when a parent brings their child to us and asks if there is any way if getting help. That strikes me as odd. It’s about data protection, but to invest in a programme and not join that [to primary care] seems a little odd.”
She said the RCGP has supported the introduction of the sugar tax and has a major Physical Activity and Lifestyle programme – run by former Gladiator Dr Zoe Williams – which it says is a “clinical priority” for three years.
Professor Helen Stokes-Lampard said: “We want to make healthy living and healthy lifestyle a normal part of what we all do. There are few GP conversations that don’t include an element of lifestyle conversation, but it’s all about tailoring it to the right time and place. A child who is brought in and depressed is not the time to talking to them about their weight.”
Professor Stokes-Lampard said the RCGP has been working hard to “change the negative narrative” surrounding primary care, with many younger doctors concerned about their future in the NHS with a constant flow of stories about GPs struggling to cope with rising demand on primary care.
“We’re trying to change the narrative, to reassure younger doctors that actually general practice – when it’s adequately resourced and supported – can be an amazing place to have a career.
“And that hard work to try and turn some of that negative spin has been successful in terms of higher numbers than ever going into general practice this year. We haven’t seen a drop in the numbers, it’s going in the other direction and we’ve been working hard to do that.”
Problems remain though. Research conducted for the College by Ipsos MORI among RCGP members shows that almost two in five GPs say they are unlikely to be working in the profession in England in five years, sparking fears that unless progress in delivering the GP Forward View is accelerated, the profession could reach breaking point.
Professor Stokes-Lampard said: “People are fearful about the pace of change in general practice, in terms of being forced to work in different ways. I think patients and doctors are finding the pace of change unsettling, and doctors complain patients are confused – they don’t know where they should be going and who they should be seeing, and that leads to extra work as people who are doubtful go and see their GP.
Whereas in fact there are services being set up for them, they just don’t know how to access them.
“I think we have a communication challenge in the NHS to streamline the services we offer, to have fewer ways into the system so people know to go one way or another way. It needs to be simplified and harmonised: so what you do in Blackpool is what you do in Brighton is what you do in Birmingham.”
“We’re still the finest [health system] in the world, despite the trials and tribulations. the UK is an amazing country and the NHS is still the jewel in our crown and people are very proud of it. It is more financially constrained now than it has been for decades, but that is the inevitable consequence of the 2008 recession. That has finally all caught up with us over the last few years and it takes time to come out of that.”