A TEAM of Scottish researchers is to publish a report showing that missed targets for finance and performance in the National Health Service across the UK are directly linked to “fragmentation” due to cuts in general practitioner and district nurse services.
The researchers from NHS Greater Glasgow and Clyde will give their findings to the Royal College of General Practitioners (RCGP) at its annual conference in October.
They will provide evidence that despite record investment in the health service north and south of the Border, and despite record numbers of employees, the cuts to GP funding and services have directly affected NHS targets.
The Scottish researchers say that GP funding cuts and erosion of services that closely support family doctors, such as the district nurse service, have adversely affected the NHS gatekeeper function.
Cuts to social care have also had an effect and in turn this has led to fragmentation within the NHS which in turn has been unable to control costs and demand.
RCGP Scotland has been calling since 2013 for the share of NHS Scotland funding received by general practice to be incrementally raised to 11 per cent, to halt and reverse a decade of cuts.
To date, funding has only been increased to wider primary care.
Dr Helene Irvine, consultant with Greater Glasgow Health Board, is a lead author of the latest research and is scheduled to speak at the RCGP conference on "how central funding strategies are disabling general practice in Scotland and England".
She told GPonline: “By investing substantially in everyone but the GP and their key ally the district nurse, we have created a very expensive, fragmented service that is not efficient and results in overdiagnosis.”
She added: “We have financial failure and overspending, difficulties recruiting staff to certain specialties, expensive locum costs to keep it all going.
“Looking at the totality of the NHS north and south of the Border, we are spending more than ever, with more people on the payroll than ever, but failing on performance targets like four-hour A&E waits.”
Irvine, a former GP herself, said referral targets were also being missed and patients with cancer were waiting longer than they should.
She added: “I’m arguing this is because of the increasing fragmentation of the NHS. We have reduced the joined-upness of it despite the rhetoric about integration.
“And the key bit essential to making it all work and controlling overdiagnosis is the GP.”
RCGP chairwoman Dr Maureen Baker said: “General practice is the cornerstone of the health service – it keeps the NHS afloat and our patients safe, so it is vital that our profession receives the necessary level of funding so we can continue to provide quality care across the UK.
“This valuable research reinforces what the college has been saying for years, underpinning the crucial need for investment in general practice, in the best interests of the health service and patient care.
“GPs and our teams make in excess of 370 million patient consultations a year – at least 60 million more than five years ago – yet the number of family doctors has increased only slightly and over the last decade, funding in our service has significantly decreased.”
A Scottish Government spokesperson said: “This year the health and social care budget in Scotland will rise to a record total of almost £13 billion, including an extra quarter of a billion pounds for social care.
“And this government is committed to further raising the NHS revenue budget by £500 million more than inflation by the end of this parliament.
“Unlike the NHS in England, all health boards in Scotland have met their financial targets for the last seven years.
“We believe that GP and primary care services play a vital, and ever more important, role in the delivery of health services and that is why we are working to develop a modern, fit-for-purpose primary care service that will meet our country’s future needs.
“To support this we will increase, in every year of this Parliament, the share of the NHS budget dedicated to primary care.”
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