23 May 2013

GP chief throws blame for A&E crisis back at Jeremy Hunt

A senior doctor attacks Health Secretary Jeremy Hunt for blaming GPs for exacerbating problems at overstretched accident and emergency departments.

Chairman of the British Medical Association’s (BMA) GPs committee, Dr Laurence Buckman called Mr Hunt’s claims childish, superficial and misleading, accusing him of bungling the introduction NHS 111, a non-emergency number for rapid medical advice and passing the blame to family doctors.

The health secretary defended his position, insisting the problems seen in accident and emergency departments in recent months are partly the result of ageing demographics but also because out of hours care does not work properly under the 2004 GP contracts.

Dr Buckman is due to make his case to the BMA’s annual GP conference later.

Complex problem

And he told the BBC Radio 4 Today programme the health secretary “keeps keeps on tweeting and speaking a childishly superficial and misleading analysis of a very complex problem.

“GPs are fed up of being blamed,” he added. “It was GPs who had to step in to rescue his botched introduction of the NHS 111 system, a perfectly good idea ruined by political posturing.”

“GPs are fed up being the whipping boy for all this. We have tried to solve his problem and he has consistently refused to listen to simple advice. You could have made NHS 111 work, instead it’s been a dreadful mistake.”

Dr Buckman said if GP contracts had been to blame for problems in accident and emergency, it would have been apparent since 2004 when they were reformed – not only in recent months.

‘Incessant accusation’

“The biggest problems have been recently, and stoked by the incessant accusation it is something to do with GPs,” he said.

“People who go to A&E are not going because of GPs. There is no doubt some of it is because people are confused about how to get access to out of hours services and some of it is because NHS 111 is sending people there.

“But some of it is about a rapid rise in demand. We are seeing more people than ever before.”

Responding on the same programme, Mr Hunt said: “It’s a complex problem and the main issue we are dealing with is a big growth in the number of older people… in the next few years we will have several million older people who have not one, not two but three or more complex conditions.

“The argument I want to make is that we need to have a clinician accountable for those people when they are outside hospital just in the same way a consultant is responsible for them when they are inside hospital if we are going to give them the kind of care we all want the NHS to do.

“It’s a big change and I think the GP contract is part of the problem.”

Mr Hunt said he did not want to return to the days of GPs getting calls directly from patients at 2am, adding he acknowledged GPs worked extremely hard.

“What I question is whether we are allowing them to do the things they went into general practice to do,” he said.

Ticking boxes

“What they want to do is to take personal responsibility for some of the most frail and vulnerable people on their lists. What we make them do on the contract is make them tick lots and lots of boxes.

“I want to change that. I think the current GP contract is fundamentally flawed by removing responsibility for out of hours services from GPs.”

Labour’s shadow health secretary Andy Burnham said: “David Cameron and his Health Secretary keep blaming GPs and the 2004 contract for the pressure in A&E despite a clear statement from the NHS Confederation that there is no link between the two.

“In addition, Jeremy Hunt has received official advice identifying other reasons for the pressure, such as the botched introduction of the 111 service and the severe cuts to social care.

“By picking on a convenient political target, the Health Secretary is failing to face up to the real causes of the chaos. That cannot be allowed to continue as the pressure is not going away and it is his job to find solutions.”