Dr Peter Moore: The NHS will not be fixed until general practice is fixed

Every politician argues that prevention is better than cure. We must push for earlier diagnosis and more health education.
The knee jerk reaction is to suggest more screening tests but there is one vital service which can lead to earlier diagnosis and ultimately save lives: general practice. There is a large body of evidence comparing countries and health systems which have consistently shown that one of the most important ways to prevent illness is to have a personal doctor. But today this is being eroded.
I am delighted to see the large amount of building work at Torbay Hospital and the proposed health hub in Torquay but most people’s first port of call in the NHS is the GP. Last year GPs carried out a record 340 million appointments in England. Many local practices are working out of old Victorian buildings or health centres built in the 1960s and 70s. As new housing estates are built all around the Bay the current surgeries cannot cope.
When people cannot get to see a GP they go to A&E. This understandable but leads to demands from hospitals to increase the A&E department. This is like calling for more buckets when the roof is leaking rather that fixing the roof.
So why is General Practice in crisis? Nationally there are at least 950 fewer full time GPs than in 2019. Although the Government promised an additional 6,000 GPs we are currently loosing experienced GPs faster that we can train new ones. Over a third of GPs plan to leave in the next five years.
One of the myths I’ve had to fight all my life is the idea that I was 'just a GP', nowhere near as qualified as a hospital consultant. GPs are consultants in primary care with distinct expertise and experience in family medicine. The current chair of the Royal College of GPs described it as 'whole patient care'.,
GPs know their community, the families and problems faced by their patients. After a while the GP will know the patients and recognise when someone is 'not themselves' even if the condition does not tick all the boxes in the latest protocol.
So how can things improve? The Royal College of GPs have made several suggestions. It is clear that we need more GPs but the present system is not working. There has to be a 'retention programme' giving GPs fully protected time for support and study. This will also mean more GP trainers and these trainers also need more time.
It has been assumed that, unlike hospitals, General Practice can soak up whatever comes along but even general practice has a breaking point. There needs to be a system of alerts to support practices when the pressures are overwhelming as we already have in hospitals.
We know that people in the most deprived areas have the worst health outcomes and yet the poorest communities in the country have over 14 per cent more patients per GP and receive seven per cent less funding than wealthier areas. In Torbay we have some of the most deprived areas in the South West.
There must be investment in premises by building new health centres where GPs can work with other community services and have more diagnostic equipment.
It is estimated that GPs spend a third of their time on bureaucracy. This is not a sensible use of an experienced GPs time.
Every pressure group wants more money. Money is tight and building new shiny hospitals might get more votes than investing in General Practice but the economic argument is strong. The NHS confederation calculated that for every £1 invested in general practice in needy areas at least £14 is delivered in productivity.
Allowing general practice to crumble is like allowing the foundations of a building to crumble while spending money inside on the wallpaper. The NHS will not be fixed until general practice is fixed.