A Major Challenge for the NHS

General practitioners (GPs) in England have voted overwhelmingly to take industrial action in protest against a 1.9% increase in public funding for surgeries. This action, while not a full-blown strike, will see GPs working strictly within their contracts, potentially leading to longer wait times and reduced access to care for patients. This poses a significant challenge for the NHS, already struggling with backlogs and staff shortages, and for the new government aiming to fulfill its promises to reform and improve the health service.

While junior doctors in hospitals have recently received a 22% pay rise, GPs operate as independent contractors, facing unique pressures as small businesses. Their sole customer is the NHS, which negotiates their pay and services on a national level. This arrangement dates back to the NHS's inception in 1948, when autonomy and the ability to take on private patients were seen as crucial incentives for doctors to join the service.

The current industrial action will inevitably make it harder for patients to see their GP. Surgeries will remain open, but the number of patients seen each day will likely decrease, leading to a more intense scramble for appointments. This could force some patients to seek care at A&E departments or walk-in clinics, further straining these already overburdened facilities. Others may opt for private healthcare, further fragmenting the national system. Ultimately, this situation could harm some people's chances of early diagnosis and worsen health outcomes.

The situation is further complicated by the closure of some GP practices due to financial inviability and the ongoing debate about the role of physician associates, a new type of healthcare professional. While the government sees them as a cost-effective way to deliver primary care, GPs fear they will compromise diagnosis and patient care.

Politically, this situation highlights the complex challenges facing the NHS, regardless of which party is in power. The new Labour government faces the same financial constraints and structural issues as its predecessor. While Streeting has expressed willingness to negotiate, the recent success of junior doctors in securing a pay rise through strike action may embolden other groups to follow suit.

Streeting's proposed solutions include moving GPs onto the NHS salary structure and creating multi-disciplinary Neighbourhood Health Centres. However, the long-term sustainability of GP partnerships remains a major question.

The potential dangers of this situation are significant. If the government fails to improve patient satisfaction with NHS care, it could fuel calls for privatization or a shrinking of the service. This would ultimately harm both patients and healthcare professionals. The BMA, representing GPs, should recognize that constant strikes and long wait times will erode public faith in the NHS, ultimately harming the interests of all involved.