Miliband vows to restructure GP surgeries and do away with quangos
A Labour government would put an extra £100 million into GP surgeries in England to pay for an additional three million appointments a year and guarantee NHS patients can see a doctor within 48 hours, Ed Miliband has announced.
Mr Miliband said the cash would come from abolishing the market framework introduced by the coalition Government and reducing spending on consultants and senior managers.
He released figures obtained through freedom of information requests showing that health commissioners and trusts are spending at least £78 million a year on new competition requirements, and cited official figures showing that the key quangos of the Government’s NHS reorganisation – Monitor, the Trust Development Authority and Commissioning Support Units – are spending £55 million annually on consultants and very senior managers.
In a high-profile speech in Manchester, Mr Miliband said it was a “scandal” that numbers of patients getting a GP appointment within 48 hours had fallen from 80% under Labour to just 40% now, while a quarter of people are now unable to get a GP appointment in the same week.
Accusing David Cameron of having “broken his bond of trust with the British people” on the NHS, he said that difficulties getting GP appointments were increasing pressure on A&E departments, as patients turn up at casualty because they cannot see their family doctor. A 5% increase in patients seeing their preferred GP could cut emergency admissions by up to 159,000 year, saving the NHS £375 million, he said.
Under Labour’s plan, every NHS patient contacting their surgery would have the right to consult a doctor or nurse the same day, with a face-to-face appointment in the surgery that day if they need to be seen quickly. Those who do not need to see a doctor or nurse immediately, and whose problem cannot be dealt with remotely, would be guaranteed an appointment within 48 hours.
Meanwhile, patients would also be give a right to book non-urgent appointments with the GP of their choice more than 48 hours in advance.
“This will be better for patients, because they have better access to their GP surgery; better for the NHS, because it will save money currently spent in A&E; and better for Britain, because it is the kind of health service we need,” Mr Miliband said.
Mr Miliband acknowledged that a Labour government elected in 2015 would not be able to match the spending on health achieved under the previous administrations of Tony Blair and Gordon Brown.
“We will have to do things in a new way to make our health service better, to save money where we can – and make sure that every single penny is well spent,” he said.
This would be achieved by putting principles of “co-operation and integration, not competition and privatisation” at the heart of the service; integrating mental health, physical health and care for the elderly; and investing in preventative care at the family doctor level.
Mr Miliband accused Mr Cameron of taking on new powers to close down health services, presiding over an increase in patients waiting four hours or more in A&E and shutting a quarter of NHS walk-in centres.
And the Labour leader said: “He promised there would be no more top-down reorganisations. But he spent billions of pounds on a top-down reorganisation that nobody wanted and nobody voted for which has put the principles of markets and competition at the heart of the NHS like never before – a boost for the private companies and competition lawyers, a burden for everyone else.
“Competition, fragmentation, and privatisation – that’s how the Tories see the future of our NHS and that’s why it is going backwards.
“David Cameron has broken his bond of trust with the British people on the NHS. He has proved the oldest truth in British politics: you can’t trust the Tories with the NHS.”
A Conservative health spokesman said: “This is an unfunded pie-in-the-sky policy that Labour can’t pay for and doctors can’t deliver. More unfunded spending would mean more borrowing and more taxes to pay for it. It’s the same old Labour.
“The last Labour government vandalised the relationship between GPs and their patients by introducing tick-box targets and scrapping family doctors, something we are now putting right.
“Far from improving access, another top-down target will leave GPs less time with their patients and put more pressure on general practice. The real solution is less micro-management and more GPs, something we’ve already committed to.”
The Royal College of General Practitioners (RCGP) welcomed the announcement but warned that it must form part of a wider shift in funding towards family doctors.
RCGP chair Dr Maureen Baker said: “There is a growing crisis in waiting times to see a GP across the country, and it is clear that this will become a key issue at the next election.
“GPs want to provide better access for their patients, but are being prevented from cutting waiting times because of the funding black hole in general practice. Ed Miliband’s announcement that more money should be channelled into general practice is therefore extremely welcome.”
She warned that “general practice is now teetering on the brink of collapse” and was “disintegrating before our very eyes”.
“Family doctors now regularly consult with up to 60 patients a day, with the majority of GPs now saying that they fear missing something serious in a patient due to unsafe workloads.
“General practice delivers 90% of NHS patient contacts for just 8.39% of the NHS budget. This is simply shocking and unsustainable for patients, GPs and the wider NHS itself.”
She added: “While we welcome Mr Miliband’s announcement it must not be another ‘sticking plaster’ solution but part of a broader, long-term, shift in investment. Ultimately, general practice needs 11% of the NHS budget by 2017 in order to cut waiting times and guarantee safe care for our patients.”
NHS Confederation chief executive Rob Webster said: “Our members tell us that the best prescription for primary care is not just additional money but also more collaborative working between primary care, hospitals and community services, and other partners like social care.
“The NHS Confederation supports the use of competition wherever it benefits patients and the taxpayer, as NHS Clinical Commissioners (NHSCC) called for in their manifesto launched last week. Like NHSCC, we believe that ‘the rules are not your enemy’ and should be applied appropriately.
“We support Monitor’s role as a specialist sector regulator which offers some protection against the generic, inappropriate application of existing EU and UK competition law to the NHS. Labour’s proposals would not abolish competition in the NHS and it is important there is a regulator to ensure that it operates in the interest of the patient.
“We also believe that commissioners need the appropriate expertise to make effective decisions about meeting the needs of their populations. Any changes to commissioning capability – whether in CCGs or CSUs – should be tested against the impact on their ability to do so. The last thing the NHS needs is more forced reorganisation.”