If you listened to Wes Streeting and the government, the problem with supplying more appointments in the NHS is all down to a shortage of GPs, and they are years away because of the time it takes to train them.
Except that is not true. In fact, it is the exact opposite of the truth. As a letter from the British Medical Association (the doctor's union, in effect) to Wes Streeting says:
What are they calling for? This:
That looks eminently sensible in the light of everything that the government says it wants to do. After all, why wouldn't you want to put newly trained doctors to work as GPs, which is what they have trained to be, when that makes the lot of everyone in the UK a bit better?
Who knows what answer Wes Streeting might provide to that question, apart from 'Rachel says no'?
What we do know is that the fear that the BMA highlights is real, and that is a damning indictment of Labour, its budgeting, its ability to prioritise, its ability to deliver on its promises, and its concern for people in the UK, including those it might employ.
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I am old enough to remember that back in the 70’s there was concern about the PIT – Pool of Inactive Teachers so why are we not doing something about the PID & PIN – Pool of Inactive Doctors/Nurses?
Clearly if we could guarantee employment for every qualified & suitable Doctor & Nurse it would do a lot both to help the NHS deal with demand and reduce the stresses on those currently in post
Expressed another way: I can lend myself any amount of money I want, without limit (albeit with some boundary conditions).
There is no shortage of docotrs trained as GPs plus:
https://www.theguardian.com/society/2025/may/26/almost-a-quarter-of-elective-operations-in-england-cancelled-at-last-minute
The money I lend to myself could sort these problems out. Fast.
But US private health rapists (well what would you call them?) are whispering in my ear & I have to find reasons to show that the NHS is not fit for purpose, after all, who else will employ me once I lose my seat.
& there, dear readers, in a nutshell is how the corrupt traitors who pretend to run the UK think. I see that Rachel from accounts has found £113bn (funny that) but it seems this will be mostly CAPEX spending, not OPEX spending. LINO, human shit-stains pretending that they care.
You may be horribly right
What we see all the time is British Politicians consulting AMERICAN health corporations, either here or in the States. Why? There are much better alternatives just across the Channel and North Sea.
It is the same when it comes to looking at prison systems and schooling.
I think we know the reason.
The only thing I respect about the Irish TD’s is that some years ago they sent a delegation to look at the USA’s ‘health service’. They decided that this system would destroy Irish manufacturing because the insurance health costs would make it uncompetitive by increasing the cost of labour. That’s why all the USA manufacturing companies have moved off shore.
Beware, UK.
I may be wrong, but I read that the £113 bn was to be spent during the next government. Does that mean after 2029? If so, it is a meaningless undertaking as there won’t be another Labour government.
It’s a puny sum….
The same probably applies to teachers too. Whilst I don’t have a letter to prove it, there is plenty of evidence that senior, experienced, better paid (well, actually, less badly paid) teachers are being pushed out in favour of junior, less experienced, and, crucially, cheaper teachers.
At a time when education is under immense strain the government should be employing the available resource of these experienced teachers to invest in education. Such investment would pay large future dividends. But they are not. Yet another government failure.
Sorry to deflate the anger against government but the Leadership College (Nottingham) that most prospective senior leaders attend for a qualification has taught, off syllabus, since establishment ” hire under 30s females – they don’t unionise, will work all hours, do t challenge, and if they burn out within 2 years you can get another”. I’ve told that to several colleagues over the years as they attended there, was scoffed at, then on return had their astonished confirmation. This was the philosophy of the Nottingham heads who were influential in its founding.
Mike is right.
When bad things need to be done, the worst most underhand means will be used and our government – in a ‘democracy’ – will manufacture the change none of us wants.
Investment – money – is the oxygen of what we perceive as quality in terms of adequate capacity to deal with the nations health. The easiest think to do is to just cut off the financial support.
Look about you………look at the disused railway lines, railway stations, torn up tramways, the crisis in bus networks. The government caved in to the auto industry, one of its ministers had strong links to a construction firm that built motorways and hired Dr Beeching and now look at where we are.
When the government doesn’t want it, it will not have it. No matter what you or I think or any amount of ‘unknown knows’.
There was a wonderful young doctor at my GP surgery last year. He was finishing off his training there and everyone said he was one of the best doctors they had ever met.
He helped me enormously at a challenging time, but sadly there wasn’t enough money to keep him there.
Everything has become about profit, rather than service, and that is what is at the heart of the creeping malaise that has affected this country since 1979.
Starmer’s line about being a ‘government of service’ was utter rubbish.
What you describe Graham is typical behaviour aimed at making the health service attractive to ‘investors’ and has been used by your ‘democratic’ government for years to strip out cost in preparation for privatisation all over the public sector.
These newly trained GPs will have the option to:
a) leave the country for another eg Australia
b) leave medicine or
c) find employment in private healthcare. – and that is how the NHS will be killed. Can’t get an appointment with your NHS GP, but easier and easier to find a private GP. Once only available in London, now available across the country – in the wealthier areas first of course.
I can see GPs going the same way as dentis.
What we have is a 2-tier system of NHS v Private. Where I live there are several private practices and one that does provide NHS services exclusively for those entitled to free NHS dentistry – mainly benefit claimants and children. These patients are usually seen by newly qualified dentists on short term contracts who then move on.
How did we get here?
In the early 1990s the gov changed the terms of the NHS contract – sorry don’t have precise details to hand.
Anyway, my dentist, along with many others, decided to withdraw from the NHS system and only practice privately.
He wrote to all his patients explaining that he did not believe he could meet their needs within the constraints of the new funding arrangements. I know he made this decision reluctantly and with a heavy heart. He was not driven by profit. For him it was a matter of ethics. He never felt the new arrangements were adequate to meet the needs of his patients incl employing support staff – nurses, hygienists etc. and keeping up to date with advances in equipment and procedures. Many of which were not available under the NHS by then anyway. I stayed with him because I trusted him and fortunately could afford to.
BUT I was angry at the time that this had been allowed to happen. Why should I, because I could afford it, get a “better” service than those paid for by the punlic purse? Why had dentists been put in this impossible position?
Now I feel the same re GPs.
We MUST NOT let this happen.
Agreed
But, how?
I know this is a tough one.
My approach is to tty and be
as informed as possible and join the “awkward squad”. In this case join the patient liaison group at yout GP surgery and express your views – if you can.
GPs are not the enemy the
neoliberal system is. (There is no money brigade!)
I live in Nova Scotia. My doctor, in private practice which is not uncommon here but paid fully by Nova Scotia Health (NSH), is planning to retire. NSH found two doctors to replace him, one from England, one from Scotland, and converted the practice to an NSH Clinic. I now have the best doctor ever!!! (Thank you!!) There are lots more openings in Nova Scotia for your doctors if Wes Streeting doesn’t want them or wants them to work for American HMOs. And, believe it or not, we have a right-wing Conservative provincial government (healthcare is a provincial jurisdiction in Canada) that would love to privatize but there is enormous pressure on NSH to keep services public. We have some wins and some losses but we are still fighting.
It’s that simple – more and more unemployed GPs, alongside GP practices not able to employ them as people wait weeks to get appointments.
Its so simple that if people knew – they would immediately understand. But will you hear it put to Streeting on BBC ? Of course not.
And as for ‘are you sure we have no money to employ them?’ Forget it.
This is managed democracy – a controlled democracy – maybe because the information is so distorted – its 1984 , its Chomsky’s ‘manufacturing consent’
This is a larger-scale rerun of what happened in summer 2015, when graduating medical students could not get their first hospital appointments for six months (they have to serve four six month terms), as hospitals were told to stop recruiting so as to stay within budgets.
It’s a classic example of what the journalist Sam Freedman calls “Treasury brain”. Or, to quote Stephen Flynn in the context of the Post Office scandal, “Nothing changes. Nothing ever changes”.
Only major democratic reform, replacing absolute central power by dispersed power, can ever fix this nonsense.
https://jujuliagrace.substack.com/p/why-isnt-keir-starmer-giving-gps
I learned of this from Julia – with whom I cooperate on occassion.
I am a type 1 diabetic and it is becoming harder and harder to see my specialist in Oxford – even getting an appointment which in 2005 was easy and convenient is now impossible.
I see the increasing prevalence of the US Health Care giants foaming at the mouth at the prospect of privatising the care and charging me exorbitant amounts for my Insulin…
There is no saving any of us because if this is Labour imagine what reform would do? The same perhaps quicker?
God speed.
I am sorry to hear.
As my wife – a retired GP – has said – the idea that human relations can be sped up is not just wrong, it’s dangerous.
Workforce planning is a shambles in the NHS and scrapping NHS England is unlikely to improve things. We have increased medical school places but there is now a severe bottleneck to get into specialty training after trainees complete their two foundation years. Competition ratios to get training places in most specialties have zoomed up and UK doctors have also faced competition from international medical graduates (but I think Streeting may address this).
Then there is the availability of consultant/GP positions.
Underlying all this is really just one word: underfunding.
Good article:
https://academic.oup.com/pmj/article/100/1184/361/7513585
The overall position seems bleak. There’s a shortfall of over 110,000 in the NHS workforce. Patient satisfaction levels and staff morale are through the floor.
The government has made a few commitments but essentially isn’t effectively addressing the staffing crisis. There is a growing gap between ambition and delivery on the ground. Unless pay, morale, and immigration contradictions are resolved with urgency, the NHS will simply continue to face staff shortages and declining service quality.