We’ve launched our 2017 manifesto!
NHA co-leader Dr Alex Ashman: “Strong and stable just isn’t good enough – we want a government with a heart.”
Here’s the full press release:
The National Health Action Party have today released their 2017 Election Manifesto. Dr Alex Ashman, junior doctor and NHA co-leader,
“We are constantly being promised a public debate about the future of the NHS. The time to have that debate is now, at the ballot box. We want an honest and open conversation on how our public services are run.
We want the public to be given the facts so they can make an informed choice as to who runs their country. Opaque references to ‘sustainability’, ‘transformation’ and ‘accountable care’ in long documents are not enough to inform public opinion.
The conversation needs to be had on every street corner, on every bus, at every dinner table. In South West Surrey our candidate Dr Louise Irvine has got that conversation going and people of all parties, and none, are getting behind her campaign to challenge Jeremy Hunt.
Our manifesto lays out what we believe are the key themes necessary to restore our public services, our democracy, and our country. We want to see excellent education, health and support services providing the foundation for a strong economy. Above all, we want an NHS that puts people before profits. Strong and stable just isn’t good enough – we want a government with a heart.”
Read the Manifesto here: http://nhap.org/our-2017-manifesto/
- Our NHS action plan
- Public health
- Social care
- Creating a fairer economy
- Our vision for political reform
- Better access to housing
- Equal access to education
- Women’s equality
- Common sense on Brexit Read Louise Irvine’s thoughts on Brexit here.
- Sustainable development
Good stuff. Excellent start. Keep it up. How you stand on proportional representation might be useful to know. Thanks
Hi Stephen, we are in favour of proportional representation.
How are you going to pay for this?
Our budget plan is included in our manifesto here: http://nhap.org/our-2015-manifesto/
And here is a quick summary, courtesy of “M.D.” in Private Eye: https://www.facebook.com/NationalHealthActionParty/photos/a.258588957587590.54818.257856350994184/765817270198087/?type=1&theater
Item 10 in the NHA action plan for the NHS states, amongst other things, that you will: “address the crisis in General Practice with an urgent injection of funding”.
What is the nature of this crisis and is throwing more money at General Practice your only method of addressing it or is there something more systemic?
you ask if “throwing more money at it” is the answer to the problems in General Practice. I would reply that more money is necessary but not sufficient to deal with the problem. There has been a real terms reduction in funding for general practice as well as a relative reduction of funding as a proportion of NHS spending. There are now fewer GPs than two years ago when Jeremy Hunt announced his plan to recruit 5000 more GPs by 2020 and fewer GPs per head than in 2010. None of the efforts to increase GP recruitment and retention has worked.
The nature of general practice has changed substantially over the past 20 years yet the way we are expected to deliver care has hardly changed. GPs now do the bulk of management of long term conditions such as chronic lung and heart disease and type 2 diabetes. The disappearance of the “general physician” from hospitals (something all hospitals had when I was a young GP) is testament to the shift of much clinical work that was previously provided in hospital clinics to general practice. Yet we are still expected to provide that expert care in 10 minutes!. In addition there has been other transfer of work. For example with the cuts to mental health services patients with “stable” psychotic conditions, on long term medication, are being discharged from psychiatric serves and transferred to GPs. This is in addition to GPs managing the majority of patients with less severe mental illness and the majority of patients with depression. Day surgery and the early discharge of surgical patients means that the surgeon is no longer responsible for the patients wound until it is healed – previously a fundamental of surgery – so now it is GPs and practice nurses who have to do surgical follow up and deal with wound complications. The fact that so many more people are surviving with cancer means that cancer has become more like a long term condition and the follow up of cancer patients has become more the GPs responsibility. Hospitals are also transferring the monitoring and treatment of patients on quite powerful medications such as the new biological anti-inflammatory agents to GPs. We have a much greater role now in prevention and child safeguarding as well as identifying domestic abuse and providing appropriate support and referral. Patients come to us for help navigating the benefits system which is becoming more complex and difficult for people with long term conditions and disabilities. And, finally, we still have the same workload we always had from people who are worried about their symptoms, who may need further investigation or help and advice with what are often called “minor illnesses” but can be very worrying for the patient.
And patients don’t just come with one problem but a combination of acute, chronic, social and psychological – so the level of complexity has increased dramatically. Dealing well and safely with complex presentations in 10 minutes is impossible. GPs typically run late and work long hours after work catching up on all the referrals, results, prescriptions and letters they need to read and write. They are also stressed because of the fear of making a mistake. We’ve also got to spend time on professional development and education, appraisal, practice team meetings, mandatory training and so on.
This is a long response because I wanted to flesh out the ways that GP work has changed, certainly within my long career of about 28 years. In order to make the job satisfying and do-able once again we need to move to a norm of 15-20 minute GP appointments. That will need many more GPs. The Royal College of GPs says we need at least another 10,000 GPs to make the workload tolerable but to move to 15-20 minute appointments would need even more. Although it takes 10 years to train a GP from start of medical school we could rapidly improve GP numbers by retaining more GPs in the workforce: many don’t stay in general practice very long and many are taking early retirement. Stress and intolerable workload are the commonly stated reasons for this. The paradox is that if we had longer appointments as standard it would make GP once again an attractive job – the essential core role of the GP is intrinsically satisfying and rewarding, if there is time to do it properly – and we would be able to progressively expand the workforce by improving retention and increasing the number of young doctors choosing to go into GP. I remember the days, not so long ago, when there were 100 applicants for every GP job. Now 1 in 12 GP posts is unfilled and many practices have given up trying to recruit. Those that remain ware even more overworked and when they become burnt out they leave, adding to the staffing crisis.
But improvement of general practice requires not just more GPs but more practice nurses, healthcare assistants, practice based pharmacists and other professionals that are central to providing good primary care.
This does require more money. Practices cannot employ the staff they need if they don’t have the funds to do so. They can’t improve the range of services they provide without adequate funding. They can’t extend opening hours without the funds to pay the staff to work during those hours.
It’s not about “throwing money” at something – that language betrays an inadequate understanding of the problems – its about funding the changes that are needed to enable general practice to thrive. And when general practice thrives patients benefit. General Practice is still highly valued by patients and what they value is that their GP or nurse has time to spend with them, time to listen and explain, and show care and compassion, as well as good clinical skills. All this requires there to be enough GPs, nurses etc. to give patients the time and care they need, in a setting that supports staff to do high quality work, not one that leads to almost burnt out people rushing through a long day to try to keep on top of an ever burgeoning and stress inducing workload.
So, yes please do throw some more money at General Practice – it will pay huge dividends.