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Senedd launches inquiry into the future of general practice in Wales

By Emily Price
GP surgery waiting room - Image: Canva

The Senedd’s Health and Social Care Committee has launched a major inquiry into the growing crisis facing General Practice (GP) services in Wales.

The probe will aim to deliver practical recommendations to the Welsh Government to secure the future of GP services.

Key evidence sessions will begin on Thursday (July 10) bringing together members of the general practice workforce from across Wales to hear directly about their experiences.

A panel of professionals will give evidence to the committee in a public session this afternoon at 12:15pm, shown live on Senedd.tv.

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Concerns

The experiences of GPs, a practice nurse, and practice manager have also been captured in a video to provide first-hand accounts of the key concerns.

This includes fears about the funding model, workforce recruitment and retention, and the impact of negative public and political discourse on morale and patient care.

Dr James Pink, a GP partner, explains how flaws in the funding model is damaging services.

He said: "It doesn’t really work in Wales, it means we’ve got a problem in this area where we are the lowest funded health board in the whole of the UK.

"Clearly our patients are the main people who are most impacted."

Dr Meilyr Gruffudd warns an increased workload is placing an unbearable pressure on GPs in Wales.

He said: "I often work in the evening and on days off. Being able to recruit more staff would help - but we can’t afford to employ them.

"The increase in the National Insurance payment is equivalent to the salary of one staff member."

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Morale

John Williams, a practice manager and partner, says a negative narrative is damaging morale and staff and patient relations.

He said: "There is an unfortunate narrative that GPs are not seeing patients.

"It impacts staff retention, recruitment and morale, but also lowers patients expectations and makes relationships difficult."

Nia Boughton is a consultant nurse for primary care.

Among her priorities is urgent recruitment for a workforce that is nearing retirement.

She said: "I’d like to see investment in the workforce in primary care nursing. 50% of our workforce is over the age of 55.

"If we don’t act quickly now we face a catastrophe."

Vital

More comments will be documented in a video on the Senedd website, along with more information about the committee’s work.

Chair of the Senedd’s Health and Social Care Committee, Peter Fox said: "We are embarking on a vital inquiry to uncover the root causes of the pressures facing our GP services.

"From the video evidence already submitted, it’s clear that the service is under significant pressure, leaving us in no doubt about the importance of this inquiry.

"We know the frustrations felt in communities across Wales, and we are determined to listen, scrutinise government action, and recommend solutions that must be acted on without delay.

"We’re grateful to the many healthcare professionals joining us today. Their evidence will be central to this inquiry, which will be our priority throughout the Senedd’s autumn term.'

More evidence sessions with Health Boards, patient representatives and other stakeholders will proceed from September onwards.

Evidence gathered will be put to the Cabinet Secretary for Health, Jeremy Miles, when he faces committee scrutiny before the inquiry reaches its conclusion.

A report containing the committee’s recommendations will be published and presented to the Welsh Government for a response, ahead of a debate in the Senedd.

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14 comments

Mab Meirion

GPs not seeing patients, it varies between practices, GPs will tell you...perhaps they can let us in on their problem with Bronglais and the magic carpet to the medical wonders of South Wales...

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hdavies15

Don't look southwards MM. The route to getting any kind of "service" is a severe obstacle course yet any time I visit to chase up my periodic blood test I see the same old faces on the benches, like they have a season ticket for the joint ! Some of the professionals are hard working but I've grown to suspect that there's a long trail of idlers dragging along behind them in local clinics and further on in the service supply chain.

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Mab Meirion

Never really house trained, GPs...they still hanker after the good old days...BNB

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Bart

Time to nationalise primary care. Couldn't GP surgeries be merged with community hubs?

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Barry Pandy

Great idea. After all the current setup only exists due to the necessity (as Aneurin Bevin put it) to 'stuff their teeth with gold'.

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Smae

GPs don't make as much money as you might think, that's not where the money drain is. It's probably not the best value for money... but there's much more fertile opportunities to harvest first.

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Smae

None of this addresses the root cause of the problem. Our NHS is currently top heavy, whether those are extremely well paid surgeons, or administrative managers but we also demand too much of staff. We've long been under the mistaken impression that as long as we pay a little more, we can overload the staff with yet more work and we've grown far too complacent with using agency workers. Cut these costs, start with Agency workers. Agency workers should be employed for no more than 5 years at a time and a plan must be in place to put a proper trained nurse in the role, if that means the hospital has to provide scholarships, then this is what will have to be done. People underestimate wildly how much it is currently costing the average medical student to become a nurse or doctor. In all honesty, due to the crisis we have, the government should be providing fully paid (aka free) medical tuition to UK citizens who want to become nurses/doctors. Cut reliance on 'consultants' I don't mean the doctors, I mean the people often brought in to advise on various matters. These are often also paid absurd sums of money. Either cut the money they are offered or cut them out. There should be a hard limit per job of what a consultant should be able to charge and the NHS should not pay above it. Take a look at administration, there is a lot of work that needs to be done back office but the vast majority of this work should be done at somewhere between the 25k and 45k salary mark. Re-distribute and break down the work into manageable chunks, and cut the number of middle managers and yes, top brass. Check out the purchasing contracts for day to day stationery and equipment and compare this to market prices. If it is cheaper for example to purchase something from say Curry's than it is to use the internal catalogue (it often is) then make the purchase locally, and then get rid of contracts that are consistently over charging or under-delivering. Start looking at smaller providers and offer 'pilot contracts' to allow 'competition' between the suppliers. Consider Free and Open Source software, even if it has to be forked and vetted this will produce long term benefits over time (never mind cutting out wasteful commercial contracts no one actually needs to use MS Office when LibreOffice does just fine). These are just a couple of things straight off the top that will free up a lot of money, some could be done today, others will take between 5 and 10 years. This money can then be sent directly to the front line of the NHS, GP Surgeries, A&E workers and junior doctors. Will we see any of this being introduced? No, why? Because some people have their snout in the trough and are more than comfortable with the current gravy train. I'm not even talking about reducing funding in the slightest, this is hospitals and the NHS actually putting money where it will have the most impact.

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hdavies15

Anybody caught walking about in a grey suit or similar civvies and identifiable as "not engaged in service delivery" should be placed in a monthly draw. "Winners" would get dismissed and not replaced.

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Amir

They can't afford to take on more doctors. But then blame the NHS, blame the doctors working and forget how previous UK Government just kept allowing the NHS to fail.

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hdavies15

.. yet encouraged the growth of an useless administrative overhead.

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Rhufawn Jones

A total joke. So convoluted to get an appointment. Difficult to get a correct diagnosis. And even more difficult to actually deal with the root cause of the problem as opposed to just masking the symptoms. Better using Google and treating yourself.

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Felicity

The phone charges to get an appointment are prohibitive if you have to wait 20-30 minutes in a queue. Once you get through, you need to be quite sick to get an appointment. No chance of having a general medical check-up.

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Smae

I'd recommend having a look at internet provider bundles that often have free calls to national numbers included, some mobile contracts (sim only) can also be really cheap on this matter. Worth a research on say moneysavingexpert to see if you can't get a better deal. You could consider calling from someone else's number (friends, family) who do have this facility or reaching out to your local community center and such if you're particularly hard up (UC not being as lucrative as the Daily Mail would have us believe). Doctors MUST provide a means of contact, if you don't have access to a phone, whether through lack of money or otherwise, they have to provide you an alternative means of engagement or they would potentially be in breach of the Equality Act. Some, I know my local does an 'e-consult' thing online, and you can request an appointment that way.

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Howie

I would say our GP practice in Aneurin Bevan HB must be a rare organisation, that does have multiple access platforms, phone, online, GP e mail for forwarding pictures of suspected ailments/injuries. The problem is referral to the next stage of the NHS in Wales, which seems hit and miss, rightly serious illnesses should be prioritised but again that can be variable. If it's about GP numbers then I'd rather have 200 GP's on central contract at £100k a year over 10 years than consigning the money to a money pit near Rhoose. It's about choices that Govts make.

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None of this addresses the root cause of the problem. Our NHS is currently top heavy, whether those are extremely well paid surgeons, or administrative managers but we also demand too much of staff. We've long been under the mistaken im...

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