A leading Newcastle GP says primary care has suffered from a huge lack of investment - and said there had been too much political attention on hospitals rather than on community care at a time when it "had never been harder" for general practice staff.
At a "Newcastle Debate" hosted by Newcastle University and on the topic of "the future of the NHS", Cruddas Park GP Dr Guy Pilkington - who also leads the North East and North Cumbria's "prevention board" looking to improve public health before problems develop - spoke of a need to ensure primary care gets the investment that is both deserved and needed to meet rising demand.
Long-serving GP Dr Pilkington told the event he felt the rapid growth in the size of secondary hospital care over his thirty-plus-year career had been striking, but that it had not been mirrored in the community.
Community doctors face considerable pressure on their premises with many working in old and failing buildings - and in October last year the House of Commons health and social care committee produced a report telling the Government: "A lack of focus on and investment in GP premises is a barrier to effective primary care provision." Discussing the wider pressures on the NHS, Dr Pilkington shared similar sentiments.
He said: "I think in some respects primary care has suffered from a lack of investment, especially compared to investment in hospitals. From when I started as a GP to now, I think the growth in funding for GPs and primary care has been a pretty small of the growth in NHS spending as a whole.
"I think when I started, there were perhaps four or five dermatologists at the RVI, now there are probably more like 15 to 20. There's been a massive growth in hospital specialisms and that specialist workforce. The problem for GPs is that investment has led to a failure to invest on a similar scale for general practice.
"That's a real shame, though we are also fortunate in that it means it's easier to create teams that feel cohesive. And when we do get it right it means people tend to stay in general practice for a long time. But things have never been harder than now for the primary care workforce."
Dr Pilkington said there was a need to arrest the circumstances which were seeing vast numbers of GPs leave the profession. The Government had previously promised to recruit 6,000 new GPs by the end of 2024 - but has recently gone quiet on the pledge.
Dr Pilkington said: "The strain on general practice is absolutely monumental at the moment. And as a result we have seen GPs leaving at the earliest opportunity - retiring as soon as they feel their pension is manageable."
He added that there was a need to see investment both in GPs and in the grassroots community organisations which support health and wellbeing in our communities.
In May the Government published its primary care recovery plan which accepted "GP numbers are not where we would like them to be, and it will take time for higher training numbers to work their way through".
The plan added: "We will do more to bring new doctors into general practice, retain those working today and encourage recent leavers to return.
"We know there is pressure on estates, particularly in areas of housing growth. Ahead of [Integrated Care Boards] doing longer-term planning, government will consult on planning guidance to raise the priority of primary care. In addition, we will support the development of a new standardised design for primary care buildings, providing modern facilities that create a positive working environment for staff and patients and use modern construction methods."
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