As The Guardian reports this morning:
[Wes] Streeting said on Monday that a Labour government would offer incentives for GP practices in England where patients were regularly able to see the same or a named doctor, and impose penalties on those less able to achieve this.
As they also report:
[The] proposal for patients to be able to request a particular GP is “an impossible ask” given the shortage of doctors, the British Medical Association (BMA) has said, heralding another possible clash with Wes Streeting, the shadow health secretary.
The BMA is right. Streeting's claim that Labour would “bring back the family doctor”, meaning patients would be able to see the same GP for each appointment if they wanted, is utterly ludicrous for three reasons.
First, doctors are not in call seven days a week, 24 hours a day. Streeting might have a 1950s fantasy that they are, but back then the number of patient contacts a GP had each year was maybe one third of what it is now. The ‘permanently on call' logic of that era worked when there was a great deal of time off between patient contacts. Now there would be little. Streeting's proposal would be enough to break any remaining commitment that GPs have to the NHS.
Second, there aren't enough GPs to do this. Choice of this sort requires slack in the system so that an option between Dr A, B or C is available at any point in time. This inevitably implies some doctor down time during surgeries. There is, however, already no slack in the system. People can't see any doctor right now, not just the one of their choice. And that is not the doctor's fault. It is the consequence of a lack of funding, about which Streeting intends to do precisely nothing. In that case his proposal is, to use a medical term, dead on arrival.
Third, this proposal is intensely discriminatory. Most women would prefer to see a woman GP. Women consult GPs far more often than men. What Streeting is suggesting is that women GPs should work much harder than men, which is both utterly unreasonable and would drive women GPs out of the NHS.
My guess is that Streeting consulted a focus group and a policy wonk, both of whom told him he had a great idea, before announcing this nonsense. All he actually proves by making such a claim is that he is as out of touch with the reality of GP practice in the NHS as Rachel Reeves is with the real needs of the economy.
It is distressing to see such incompetence on offer to the UK public when knowing that its purveyor is likely to be the next Health Secretary, where his failure is already guaranteed if he keeps taking nonsense of this sort.
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Baloney.
So, more evidence yet again of no actual new ideas (or even a retention of good ones that work) by Labour.
Instead, they seem to be The Tinkering Party because in actual fact they agree with the Tory party and the establishment that the time has come to do the most radical thing of all – run the NHS and other welfare state services down. It was all as Daniel Hannan has said ‘a big mistake’.
The individualised nature of this proposal is also telling isn’t it? Yet another promise on the back of regime of low taxation and NI rates and ‘no money’ that will help bring the service down.
GIGO in other words. Garbage In; Garbage Out.
This false competition over ideas like this is pure political theatre remember. This means that there is no real politics going between the Tories and Labour because they are just sparring over little management issues whilst the fundamental finance and policy issues are left untouched. And the rundown of what we need continues unabated.
This is Streeting and Labour courting the Daily Mail vote, like Reeves did to the Telegraph over the weekend.
Problem is, Daily Mail and Telegraph readers tend to all be die hard – and very reactionary – Tory voters. They are not likely to ever vote Labour.
It’s time Labour start speaking to its real base.
You are right, Duncan. Most Mail or Telegraph readers are not likely to vote anything else. At best they stay home. And fewer read their papers.
Many people are influenced by what their friends say. If Labour addressed itself to the wider working population, which today includes many graduates like my kids, they could be more influential.
I have heard a lot recently about focus groups and their influence. I have little knowledge about they are conducted but I doubt if anyone there explains how the economy works. My impression is that they trot out a policy and ask for views.
Sadly our media discourages in depth explanation and exploration plus we rarely see proper economists on news programs-though that depends on what one thinks a proper economist is. Not a spokesperson from the IEA.
In addition to this, the Daily Mail and the Telegraph are two of the most viciously reactionary right wing outlets around, for Labour (by pandering to them) to ‘neutralise’ their attacks is futile. Whatever Labour say or do they will attack Labour come what may – and attack Labour very strongly, as the Mail and Telegraph are Tory papers. It’s not called the ‘Tory press’ for nothing.
Whatever happened to reality-based policy?
Whatever happened to evidence-based policy?
Whatever happened to questioning the assumptions behind policy?
Having reached 60 I am one of those with a number of long term conditions
Paradoxically I prefer not to be seeing the same GP all the time.
In order for my GP practice to work and it’s one of if not the biggest in the country whoever I see has to make a proper record of my consultations and in effect I get a review of my treatment every time I am seen which and with no disrespect to all those who see me is better both for me and I suggest the medical staff who see me
Wise man….that can work well
Am I in the least bit surprised by this unrelieved drivel from Streeting and Labour? Nope.
I can only hope that once in power a significant chunk of the electorate quickly realise what a Labour government will mean from now on – including those so mawkishly insisting that Labour’s critics ought to vote for them as we don’t know what Labour will do once in power and that we must give the party a chance before judging them. If only I had some bags of magic beans to sell.
Likewise, I sincerely wish for those small groups and now free agents on the political left to organise in earnest – preferably along with larger entities such as the Green Party in some fashion to be ready to occupy the in-coming political vacuum that is going to develop from the Labour Party’s absolute lack of impactful actions and ideas to help those most in need. If these left-leaning elements fail to organise and act together then my fear is that something even farther to the right of the current Conservative Party will quickly take advantage of the opportunity.
Currently I’m observing the Labour Party’s candidate for the North East Mayor gauche attempts to copy and paste major aspects of Jamie Driscoll’s independent campaign. The country is about twelve months from the next GE and the very likely incoming Labour government is unable to field a credible candidate with their own handful of policies for such an important position – even with the significant backing of the party machinery. I can’t ever recall wanting a general election to result in a hung parliament so strongly.
Let’s face it Labour under Starmer is just an amateurish outfit. We should stop expecting much in the way of commonsense from them. Indeed we ought to call it the Lucky Dip Party. You go to the polling station to vote for them and go home not really knowing what to expect from them by way of well-thought out policies to tackle the country’s problems if they get into power.
Did Streeting even bother consulting the BMA? We deserve to know because if he didn’t he’s just an arrogant twerp or maybe he did but just ignored what they had to say just like Starmer ignores many of the wishes of Labour Party members.
https://www.theguardian.com/society/2023/aug/28/labour-to-incentivise-gps-to-bring-back-the-family-doctor
Another element in Streeting’s crowd-pleasing waffle, imposing penalties on doctors already so overworked they can’t guarantee seeing patients, reflects a further right wing element of consensus “centrist” thinking. Punitive treatment of those already over-stretched by unjust austerity conditions, which can only make the conditions and the service worse. All designed to collapse the fundamental principle of the welfare state (equal access for all – equality, the core foundation which we increasingly ignore) and replace it with the competitive element so beloved of capitalist free marketeers (which Streeting plainly is). The result will be increasing privatisation (which has worked so well in education and housing).
The heading needs changing as it reads ‘WS really should START speaking nonsense’. You probably meant STOP.
It makes sense – It does not say nonsense
“Streeting’s proposal would be enough to break any remaining commitment that GPs have to the NHS.”
Presumably that’s the point of the proposal? Get more GPs to sign up to the private sector?
Only a short while ago Streeting was talking about ending the GP contract system and making all GPs salaried NHS employees – a proposal that has not been taken up by the Labour Party. Whilst clearly this would not address the resourcing issues you rightly highlight, what do you make of it as a proposal in itself. Could it be at least part of the solution to the crisis in primary care?
I am in broad favouyr in agreement with it
But it would not save money – it would instead cost more, because people with emplpoyment contracts work to them
In addition to costing more on the grounds that GPs may do less work, there would also be the cost of the other staff currently employed by GPS and the property maintenance required for propertied currently owned by GPs. Not to mention the admin systems that would need to be in place to run payroll, HR, recruitment etc. Plus the loss of those GPs who would not wish to be employees and all the constraints on their practce that mght bring.
WHile it may have been better if GPs had been employed since the start of the NHS, changing it now would be a mammoth task, for little, if any, return.
A short while ago Streeting was talking about ending the GP contract system and making all GPs salaried NHS employees. The proposal was not embraced by the Labour Party. Whilst it clearly does not address the capacity issues you rightly highlight, what do you make of it as a proposal in itself? Could it at least be part of the solution to the growing crisis in primary care?
Apologies if this post appears twice. My first attempt failed to send.
Both have got in I think and I have answered the first
John Boxall
As far as I remember, there would need to be legislative change for the NHS to set up GP practices.
Dusting off my PhD in the bleeding obvious.
There will be some GP practices that will want to be taken over by the NHS and areas where new practices are needed presumably set up by the NHS
These surely will be the priority while existing practices are left to carry on as they are and perhaps absorbed gently later leaving those who wish to remain independent alone for a while
I am baffled as to why some commentators see Streeting as one of Labour’s rising stars. His comments all seem to be detached from evidence and reality, just pandering to the prejudices of the most right wing, and ill informed voters.
Roy Lilley (https://fabnhsstuff.net/fab-stuff/roy-lilley-nhs-writer-broadcaster-commentator-and-conference-speaker) who is always good on the NHS is particularly scathing about ‘Silly Boy’ Streeting.
Being able to get appointments with a ‘personal’ GP may well be desirable and arguably result in improved health outcomes. However, you don’t need to know much about resourcing and utilisation (and the government knows zilch), to realise that this needs a lot more doctors, working at a lot less than 100%.
I think Lilley sums him up very well.
Something I read today on NHS funding.
https://t.co/zhnQjoJO92
No wonder the NHS is in such a state, and GPs can’t cope.
This is what Streeting needs to fix, but won’t.
https://weownit.org.uk/act-now/starmer-reinstate-the-nhs-fully-public-service
Can’t imagine they will take any notice but we’ve got to keep trying.