A Labour proposal for patients to be able to request a particular GP is “an impossible ask” given the shortage of doctors, the British Medical Association (BMA) has said, heralding another possible clash with Wes Streeting, the shadow health secretary.
Streeting said on Monday that a Labour government would offer incentives for GP practices in England where patients were regularly able to see the same or a named doctor, and impose penalties on those less able to achieve this.
He also said the party would seek to regulate NHS managers in the wake of concerns about the Lucy Letby case.
Writing for the Telegraph, he said Labour would “bring back the family doctor”, meaning patients would be able to see the same GP for each appointment if they wanted.
Surgeries would receive financial incentives for doing this and those unable to offer such continuity would get less money, under a plan described as cost-neutral.
“GPs value this relationship with their patients,” Streeting wrote. “Give GPs the tools to build a meaningful relationship with patients and more will stay in the job.”
Dr Katie Bramall-Stainer, the chair of the BMA’s GP committee for England, said Streeting was correct to say fewer patients were now able to see a doctor of their choice, but argued it was vital to see this in the context of 2,200 full-time GP posts being lost since 2015.
“Combine this workforce exodus where GPs at breaking point are retraining, taking on other roles or leaving entirely with millions of patients on NHS waiting lists and we have the perfect storm,” she said.
“Every GP strives to deliver the best care to our patients in the most appropriate way we can based on patient choice, but the reality of the chronic workforce shortage makes this an impossible ask against the backdrop of increasing demand from a growing – and ageing – population.”
A Labour source said: “The policy sits alongside our pledge for the biggest expansion of staff in the history of the NHS. As Wes says in the article, we know how overstretched GPs are. As we put more staff in, we will ensure this results in a better service for patients.”
The plan, and especially the idea that some surgeries would lose financing, could nonethless place Streeting on a collision course with doctors’ associations again, after earlier criticism from the BMA when he accused the union of opposing vital NHS reforms.
Streeting said in the Telegraph that while the NHS existed to serve patients, “increasingly, patients are instead made to bend their lives to suit the health service”.
He wrote: “Patients are mainly told when their appointment will be and whether it will be in person, over the phone or via video, rather than choosing what works best for them. Why should someone who prefers to see their GP face to face have to make do with a phone call? A public service shouldn’t be telling the public ‘like it or lump it’.”
In separate comments to the Times, Streeting raised the idea of regulating NHS managers in the same way as medical staff, meaning those found to have seriously failed could be struck off a professional register.
Streeting said Letby’s murders of babies made the change necessary, after some doctors at the Chester hospital where she worked claimed their concerns about the neonatal nurse were overruled by managers.
He told the Times: “NHS leaders have enormous responsibility for the health of their patients, yet currently face less regulation than bank managers. To protect patient safety, this must change. The case for a proper system of accountability has been made again and again.”
A 2019 review of tests to ensure senior NHS staff are competent made a series of recommendations that were not taken up by ministers.
