Mr Streeting’s master plan for reforming the health service is missing many details, but its shape is clear: to broaden the scope of NHS care with less emphasis on GPs as gatekeepers, and hospitals as the first resort when something goes wrong. He tells i: “What we’ve got to do over the course of, I think, a decade realistically is shift that focus and activity out of hospitals into the community – faster diagnosis, which means more effective outcomes.”
A proposed shake-up of how GP practices work, with the NHS taking direct control rather than funding family doctors who remain self-employed as now, has raised hackles in the profession, and Mr Streeting has publicly traded barbs with the British Medical Association after suggesting doctors should work more flexible hours.
Defending his punchy approach, he says: “I’m not going to go to Rachel saying I need billions more for the NHS until I can be certain that we’re spending every penny in the NHS well already. And I think that does mean asking some fundamental questions about primary care, and how we improve access to general practice, how we can reduce pressure on GPs.”
Mr Streeting adds: “GP partnership is in decline. And new people coming into general practice are saying actually, I want to be a salaried GP, not a partner… If GP partners are saying to me, as many of them are, we don’t want to lose our model, well then people have got to come up with an alternative and persuade me that there is a future for GP partnership that would work. The door’s always open, I’m always open to challenge and criticism, but what we can’t afford to do is pretend that if we just keep things as they are that the NHS will exist as it does today in 75 years’ time.”
Pushing for greater flexibility in how patients see their doctors, he says: “I’m the sort of person, you know, 40 this month, busy at work – if I can speak to someone over the phone or on a Zoom or Skype call, that’s so much more convenient for me. And giving me that choice will free up an appointment for someone who maybe is older or not as digitally connected, or maybe has a whole load of ongoing health conditions where they want to see the same doctor.
“I understand the pressures in primary care and the pressure GPs are under, but it cannot be right that in the 21st century, people are told to ring up at eight o’clock in the morning – and the best thing that this Government offers them is better hold music.”
Mr Streeting wants patients to be able to “self-refer” for specialist treatment, for example by attending “one-stop shops or clinics” that might include gynaeocology facilities, another move that would reduce the role of GPs as the automatic first step in seeking non-emergency care. His emphasis on patient choice, even when it weakens the control wielded by public service providers, is strikingly reminiscent of the approach taken by Tony Blair.
Asked whether, like Rishi Sunak, they have used private health care, Ms Reeves replies that she had not and Mr Streeting says he only had insurance “when I was a student working at Comet”. Both emphasise that there is nothing wrong with going private in some circumstances, but claim the Prime Minister is unable to set an example by using public services for himself and his family because of their declining standards.
Ms Reeves concludes: “If you’re in a position to make our public services better then you should, and the way that we know that they’re better is that people want to use them – and even the Prime Minister doesn’t seem to want to use any public services that ultimately he’s responsible for.”
A number of a fairly positive points in the plan.
It is ridiculous that you have to ring up in a queue at 8am to make an appointment when it would be fine to schedule one in at a later point. My GP practice accepts emails, but weirdly only during opening house.
Additionally the GP being gatekeepers does result in unnecessary appointments for them to make a referral to the relevant team. On two occasions having had firstly an ingrown toe nail there surgery was always going to be in the community hospital, and the secondly having had a private ADHD diagnosis, to port it over to the NHS I had to go through my GP first, to refer to the Adult ADHD service instead of sending the application to them right away.
Biggest thing the NHS needs to do is to bring residential, nursing and home carers into its remit. The biggest bed blocking and drain on resources is the elderly people in a hospital bed, taking up nurses and NHS resource at a cost of thousands per week, instead of having a residential care bed at £800 per week etc
>[…] if I can speak to someone over the phone or on a Zoom or Skype call, that’s so much more convenient for me. And giving me that choice will free up an appointment for someone who maybe is older or not as digitally connected
I’m not sure I understand this. Opting for a telephone appointment rather than an in person one doesn’t free up a doctor.
I just can’t trust GPs surgeries any more. 🙁 Too much incompetence, misdiagnosis and lost test results.
From what I’ve been told by people that I know that have worked in the health service there are many issues that need a lot of work.
There are big problems with the running in the procurement side of the NHS in many places, there are so many different systems operating in just a few places and not across the whole country, you have the lack of integration between the hospitals, GPs and care in many places, you have houses being built in already busy areas where hospital/GP/dentist capacity is already stretched or at its limit and no new hospital etc being built in those areas to deal with the additional patients.
Reform is needed but it needs to be done after a lot of discussion with those doing the job not those in trusts or offices who aren’t working at the ground level.
Why is nothing done about dentists? We are slowly walking into a fully private dental service because NHS contracts are not worth it for dentists as private pays more.
So just skip the broad specialist and most likely self refer to the wrong one. Because what ever you just googled or because Mable down the street seen this one freckle once and you know she did her first aid that one time in the 90’s.
Do not see that ending in longer diagnosis times and larger waiting list at all.
7 comments
Mr Streeting’s master plan for reforming the health service is missing many details, but its shape is clear: to broaden the scope of NHS care with less emphasis on GPs as gatekeepers, and hospitals as the first resort when something goes wrong. He tells i: “What we’ve got to do over the course of, I think, a decade realistically is shift that focus and activity out of hospitals into the community – faster diagnosis, which means more effective outcomes.”
A proposed shake-up of how GP practices work, with the NHS taking direct control rather than funding family doctors who remain self-employed as now, has raised hackles in the profession, and Mr Streeting has publicly traded barbs with the British Medical Association after suggesting doctors should work more flexible hours.
Defending his punchy approach, he says: “I’m not going to go to Rachel saying I need billions more for the NHS until I can be certain that we’re spending every penny in the NHS well already. And I think that does mean asking some fundamental questions about primary care, and how we improve access to general practice, how we can reduce pressure on GPs.”
Mr Streeting adds: “GP partnership is in decline. And new people coming into general practice are saying actually, I want to be a salaried GP, not a partner… If GP partners are saying to me, as many of them are, we don’t want to lose our model, well then people have got to come up with an alternative and persuade me that there is a future for GP partnership that would work. The door’s always open, I’m always open to challenge and criticism, but what we can’t afford to do is pretend that if we just keep things as they are that the NHS will exist as it does today in 75 years’ time.”
Pushing for greater flexibility in how patients see their doctors, he says: “I’m the sort of person, you know, 40 this month, busy at work – if I can speak to someone over the phone or on a Zoom or Skype call, that’s so much more convenient for me. And giving me that choice will free up an appointment for someone who maybe is older or not as digitally connected, or maybe has a whole load of ongoing health conditions where they want to see the same doctor.
“I understand the pressures in primary care and the pressure GPs are under, but it cannot be right that in the 21st century, people are told to ring up at eight o’clock in the morning – and the best thing that this Government offers them is better hold music.”
Mr Streeting wants patients to be able to “self-refer” for specialist treatment, for example by attending “one-stop shops or clinics” that might include gynaeocology facilities, another move that would reduce the role of GPs as the automatic first step in seeking non-emergency care. His emphasis on patient choice, even when it weakens the control wielded by public service providers, is strikingly reminiscent of the approach taken by Tony Blair.
Asked whether, like Rishi Sunak, they have used private health care, Ms Reeves replies that she had not and Mr Streeting says he only had insurance “when I was a student working at Comet”. Both emphasise that there is nothing wrong with going private in some circumstances, but claim the Prime Minister is unable to set an example by using public services for himself and his family because of their declining standards.
Ms Reeves concludes: “If you’re in a position to make our public services better then you should, and the way that we know that they’re better is that people want to use them – and even the Prime Minister doesn’t seem to want to use any public services that ultimately he’s responsible for.”
A number of a fairly positive points in the plan.
It is ridiculous that you have to ring up in a queue at 8am to make an appointment when it would be fine to schedule one in at a later point. My GP practice accepts emails, but weirdly only during opening house.
Additionally the GP being gatekeepers does result in unnecessary appointments for them to make a referral to the relevant team. On two occasions having had firstly an ingrown toe nail there surgery was always going to be in the community hospital, and the secondly having had a private ADHD diagnosis, to port it over to the NHS I had to go through my GP first, to refer to the Adult ADHD service instead of sending the application to them right away.
Biggest thing the NHS needs to do is to bring residential, nursing and home carers into its remit. The biggest bed blocking and drain on resources is the elderly people in a hospital bed, taking up nurses and NHS resource at a cost of thousands per week, instead of having a residential care bed at £800 per week etc
>[…] if I can speak to someone over the phone or on a Zoom or Skype call, that’s so much more convenient for me. And giving me that choice will free up an appointment for someone who maybe is older or not as digitally connected
I’m not sure I understand this. Opting for a telephone appointment rather than an in person one doesn’t free up a doctor.
I just can’t trust GPs surgeries any more. 🙁 Too much incompetence, misdiagnosis and lost test results.
From what I’ve been told by people that I know that have worked in the health service there are many issues that need a lot of work.
There are big problems with the running in the procurement side of the NHS in many places, there are so many different systems operating in just a few places and not across the whole country, you have the lack of integration between the hospitals, GPs and care in many places, you have houses being built in already busy areas where hospital/GP/dentist capacity is already stretched or at its limit and no new hospital etc being built in those areas to deal with the additional patients.
Reform is needed but it needs to be done after a lot of discussion with those doing the job not those in trusts or offices who aren’t working at the ground level.
Why is nothing done about dentists? We are slowly walking into a fully private dental service because NHS contracts are not worth it for dentists as private pays more.
So just skip the broad specialist and most likely self refer to the wrong one. Because what ever you just googled or because Mable down the street seen this one freckle once and you know she did her first aid that one time in the 90’s.
Do not see that ending in longer diagnosis times and larger waiting list at all.