At a time when the NHS is under a significant amount of pressure, where patient demand so often outstrips capacity, we must ensure clinicians in primary and secondary care are equally valued for the vital role they play in providing healthcare to our communities.

There is not an access issue in general practice but a capacity issue. The longstanding workload, workforce, and morale issues are related to the chronic underfunding of general medical services. It will be increasingly difficult to bridge the demand/capacity gap until this funding deficit is addressed.

The chronic underfunding has been worsened by Welsh Government's decision to exclude GPs from last month's pay enhancement offer for the 2022/23 financial year.

Regretfully the Welsh Government chose to overlook the crucial work of primary care staff in their recent pay offer to NHS health unions, a point of great disappointment to us. 

The lack of inclusion of general practice in this offer has caused widespread upset in the Welsh BMA GPs committee and among our members. We are especially concerned about how this will affect an already-demoralised and burnt-out workforce. 

We have immediately raised this with the Welsh Government Primary Care Directorate and have continued urgent discussions with them over the past few weeks.

This decision is neither fair nor equitable. We have called for the equivalent investment into general medical services pay awards to ensure parity across the medical profession. In a letter to the Welsh Government, we have made it clear that widening the pay differential between primary and secondary care will negatively influence the recruitment and retention of staff, exacerbating the workforce crisis in primary care. 

We have outlined that GP practices employ from the same workforce pool as health boards, and therefore in a competitive market, many will feel no choice but to match the pay levels offered in secondary care.

This competition increases cost pressures on practices and must be mitigated ahead of our usual contract negotiation cycle. Ultimately, the decision is divisive among the medical profession and will negatively affect practice sustainability and viability.

We have also set out the importance of ensuring primary care doctors are included in the Welsh Government's recent declaration to honour pay restoration and ensuring they commit to influencing the UK Government and pay review body processes to deliver a better deal for all doctors. 

We are doing all we can to ensure all doctors are valued to protect the profession’s future and ensure we can meet the needs of our communities.

Gareth Oelmann is chair of the BMA Cymru Wales GPs committee