NHS: General Medical Practitioners

Question

Asked by

To ask His Majesty’s Government what was the net change in the number of NHS general medical practitioners (GPs) in England, after taking account of resignations and additional recruits, in the past three years; and how much improvement in the retention of GPs they are planning to make as a result of the NHS Long Term Plan published on 30 June.

My Lords, as of September 2023 there are 2,025 more full-time equivalent doctors in general practice than in September 2020. We are working with NHS England to increase the general practice workforce. This includes measures to boost recruitment, address why doctors leave the profession and encourage them to return to practice. Last year, a record 4,000 doctors accepted a GP training place. The long-term workforce plan has committed to increasing this to 6,000 by 2031-32.

I suppose I should thank the Minister for that rather optimistic reply, but is he aware that the number of patients has increased by 20% since 2015 while the number of GPs has actually declined? I can tell him that 464 GP partners were lost last year and that a quarter of GPs work only part-time. A recent survey by the Royal College of General Practitioners revealed that 57% of GPs are now saying they will not be in general practice in five years. Can the Minister explain how the new long-term workforce plan will get us anywhere near the number of 6,000 that he mentioned, when the plan expects a retention figure that will expand the number of GPs by only 700 by 2036-37?

Too long!

I am coming to the conclusion. Are we not in a situation where NHS England and the Department of Health and Social Care have failed and we need some new thinking to sort out the problems of GPs?

My Lords, I take this opportunity to congratulate the noble Lord on the work he did as a Labour Government Minister between 2003 and 2007. I am grateful for his question. We are incredibly grateful to GPs and their staff, whose hard work ensured that more than 32.6 million appointments were carried out until September 2023, more than two-thirds of which were face to face. On 30 June, NHS England published the NHS Long Term Workforce Plan. The plan sets out the steps that the NHS and its partners need to take to deliver the NHS workforce, including GPs, that meets the changing needs of the population over the next 15 years. We are working with NHS England to increase the general practice workforce in England. This includes measures to boost recruitment, to address the reasons why doctors leave the profession and to encourage them to return to practice. NHS England has made a number of retention schemes available to boost the general practice workforce.

My Lords, does my noble friend agree that it is also important to congratulate GPs and practices that are introducing innovations, such as weekend working, and their attention to the patients? They get an awful lot of attacks, but in my view they are in need of some congratulation as well.

I completely agree with my noble friend. The 2022 GP patient survey showed that 72% of patients reported a good overall experience at their GP practices. GP practices that innovate tend to get better results in customer patient satisfaction.

My Lords, how many doctors, including GPs, have come from outside the UK in the last year for which we have records? What long-term plan is there to stop us relying on having to bring in doctors from countries that need them far more than we do because they are much poorer than here in the UK?

The right reverend Prelate the Bishop of St Albans asks an important question but the recovery plan introduced new measures to support international medical students, who make up more than half of all doctors in GP training, so if we were to stop those students coming over we would be in real trouble ourselves. On his wider point he is absolutely right, but it is not just GPs and doctors; it is also healthcare professionals in social services and elsewhere.

My Lords, I declare an interest as a member of the GMC. On the increase in training places in medical schools, which is of course very welcome, does the Minister agree that this will not come off unless we increase the number of people training the GPs? Will he arrange for discussions between himself, the GMC, medical schools and NHS England to ensure that we get enough people to come in as trainers to enable even the modest workforce projections that are in the plan for medical schools to be put into action?

I absolutely agree with the noble Lord. If he is inviting me to do something with that, I will certainly take it back to the department based on his question.

My Lords, among the fastest-growing groups on the doctors register are so-called specialty and associate specialist doctors and locally employed doctors. These doctors are not currently able to work in primary care, although they are very skilled, and the long-term workforce plan says the Government will look into that. What progress have the Government made in talking to the relevant professional bodies about opening up general practice so that more sessions are available?

I do not have an answer in my pack to that specific question, but the noble Lord raises a very good point. It is very important that we bring more specialist skills into primary care, and GP practices are exactly the right place, but I will come back to the noble Lord on that specific point.

My Lords, what assessment have the Government made of the number of general practitioners required to meet the needs of the population and for training purposes by the year 2030?

We are working with NHS England to increase the general practice workforce in England but, as the population grows, with the amount of building that goes on throughout the country, it is the responsibility of local authorities. There are two ways to do this: they can apply for capital funding for new GP practices; or they can apply through Section 106 agreements through local authorities. It is for the regions and for local authorities to plan ahead on that front.