If not Now, When? General Practice is facing existential challenges that must be addressed urgently.

by BMA Cymru Wales media team

Press release from BMA Cymru Wales.

Location: Wales
Published: Saturday 9 March 2024
Gareth Oelmann

Dr Gareth Oelmann delivers GPCW' annual report to the Welsh Conference of LMCs

Addressing the Welsh conference of representatives of local medical committees, Dr Gareth Oelmann, Chair of GPC Wales said:

It will be no surprise to any of you if I kick off my speech today with the triple alliteration that summarises the work of the GPC Wales committee in the last year: “Workload, Workforce and Wellbeing.”

I will start by thanking the Minister for addressing conference this morning. The minister recognised the extraordinary commitment of GPs and the vital role general practice plays in our health system.

On that she is correct - but what we have also heard this morning from the Cameron Fund is a sobering illustration of the state of the profession's health - thank you Sean.

If we cannot solve the workforce and workload issues, this is a glimpse into the future and warning signs that none of us should ignore.
And in that moment of reflection, take a look at the picture on the front of your conference booklets.

The sands of time are running low, and time is running out. We have called for action from the Welsh Government, and given all the evidence, the overwhelming question to them must be "If not Now, when?"

Our communication strategy's combination of professional, political and public engagement has started to bear fruit. It continues to promote the BMA Save Our Surgeries Campaign narrative on all fronts. A campaign that has called on the Welsh Government to

  • Commit to adequately funding General Practice, restoring the proportion of the NHS Wales budget spent directly on general practice
  • Invest in the workforce of General Practice to allow the implementation of a national standard for a maximum number of patients that GPs can reasonably deal with during a working day to maintain safe and high-quality service delivery
  • Produce a workforce strategy to ensure Wales trains, recruits and retains GPs
  • Develop a long-term strategy to improve staff well-being.

Your letter-writing campaign to Members of the Senedd saw over 1,100 letters written to our sixty MSs. Many of these letters created opportunities for engagement between GPs and their local politicians, which has led to General Practice-specific questions being made directly to the First Minister and Health Minister in Senedd plenary sessions.

I am delighted that Russell George, Conservative Health Spokesperson has offered to support and sponsor a ‘Save Our Surgeries Phase 2 event’ in the Senedd later in the Summer. So that we can again put General Practice requirements into the political and public spotlight.

The public petition for 'Fair and Adequate Resourcing of General Practice in Wales' gathered an amazing 21,500 signatures. The petition has allowed the Welsh public to show their support and concern for the future of their local general practice services.

The petition attests to the fact that there is continued strong support for General Practice from our patients, valuing your ongoing commitment to their care. I feel that your work has gone a long way to heighten the public’s awareness of the root cause behind their struggles to get an appointment – and certainly changed the narrative and discourse from our politicians in the Senedd.

This debate needs to be heard on the floor of the Senedd Chamber, and we look forward to contributing toward these discussions and what may follow as a result.

It will not have escaped your attention that despite our calls for Resource Restoration and increased investment in General Practice, the Welsh Government did not present what we considered a credible offer during this year's contract negotiations.

While our position remains unchanged, and we could not reach a contractual agreement on this basis, the impasse could not continue indefinitely.

A zero-investment into the general medical services contract for 2023/24 would have been punitive and irreversibly damaging to general practice in Wales.

Negotiations were concluded without a negotiated contract agreement. Consequently, a sum of twenty million pounds, which the Minister maintains as the maximum available financial offer, will be invested into the GMS contract for 23/24.

This investment includes a minimum 5% pay uplift for all staff working in General Practice and will be backdated to April 2023.

But to put this financial offer into perspective, this quantum of twenty million pounds represents 4.4% of the GMS Contract value of £450 million, made at a point in time when CPI was running at 8.7%.

Our position remains clear that this quantum of money is sub-inflationary, inadequate in terms of unavoidable expense pressures, and does not meet the recommendations of the DDRB.

We are under no illusions that this will address the financial challenges practices face, but this pragmatic outcome will avoid further uncertainties and delays for GPs and their staff.

Our ‘Save Our Surgeries’ campaign makes clear that General Practice is facing existential challenges that must be addressed urgently. We welcome the Welsh Government and NHS Wales' acknowledgement of our calls.

There is a mutual recognition of the need for a broader debate about the priorities for Welsh general practice in future, and we look forward to these discussions in earnest, particularly around Resource Restoration.

I have taken every available opportunity to counter the narrative emanating from the floor of the Senedd Chamber over recent months.

In response to oral and written questions about the lack of GMS funding, Ministers have highlighted alternative services provided in primary care, such as Urgent Primary care centres, the 111 services and the Common ailments scheme.

These schemes are a drop in the ocean compared to the ever-increasing demand for General Practice and come at a disproportionately higher cost per appointment. These projects are not and should not be portrayed as a GMS alternative.

The Welsh Government continue to state, ‘they have no money’. Therefore, I challenge them to use the taxpayer’s pound more effectively and take stock of priorities.

A robust evaluation of new primary care initiatives that considers the comparative value of investment in these projects is urgently needed. Equivalent investment into General Practice would provide greater continuity of unfiltered holistic care to the entire population of Wales.

My direct advice to the new First Minister and their chosen Health Minister will be. ‘Recognise the value of General Practice, do not undervalue our worth. But if you continue to actively devalue GMS, the consequences are plain for all to see’.

With all that in mind, it is more important than ever that we, the GPC Wales Executive team, hear about the impact this wider context is having upon you, your immediate colleagues and the profession at large.

We are today launching the 2024 GPC Wales Workload, Workforce and Wellbeing survey, open to all GPs practising in Wales. This survey will provide us with invaluable data to inform both the ongoing Save our Surgeries campaign and the next round of negotiations.

In parallel to this vital temperature check, we have worked with the Institute of General Practice Management in Wales to develop a separate practice finance survey where we can obtain more granular data on the sustainability of practices – again invaluable information to take into negotiations. This will be launched and promoted in the coming weeks, and you should encourage your Practice Managers to keep an eye out for this.

I want to thank my GPC Wales executive team, my vice chair, Ian Harris, together with, David Bailey, Paul Emmett, and Steve Davies, for their outstanding work over the last year.

Thank you to everyone at The BMA who works constructively and cohesively for the benefit of doctors in Wales.

One of the cornerstones of the GPC Wales committee's success is the strength of our relationship with you - our LMCs and practices across Wales. Together, we have demonstrated the strength of feeling within the profession and our collective desire and commitment to fight for the future of General Practice in Wales.

I will leave you with the echo of my earlier call:-

"If not Now, When?"



Notes to editors

The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.

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