Is more money going to be spent on GP services?

There have been various announcements over the last couple of years about spending more on General Practice medicine in England and how the increase will happen.  This isn’t only important for the 40,000 GPs (just over half are women) but for the 50 million population they serve.  The main idea is to spend an extra £2.5 billion each year on GP services by the year 2020.  This will mean spending roughly 10% of the NHS budget, or about £12 billion per year, on GP services out of what will by then be a total NHS budget of £120 billion.  But, as always with NHS funding, the devil is in the detail.

A good part of the increase in GP spending is inflation-related, though there will be a significant increase in real terms.  And some of the increase is impossible to quantify at this stage because the government are asking their new and powerful Care Commissioning Groups  (CCGs) to direct some of their spending towards General Practice.  This is all part of the planned 7-day a week service so beloved of the current Conservative government.  So the CCGs will try to fund evening and weekend capacity at GP practices which is leading to much tough negotiation and inevitably a lot of regional variation.

NHS supply chain
NHS supply chain
As well as GP-spending the NHS spends a great deal outside hospitals, particularly on “Public Health”.  This includes vaccinations, screening and health visitors, but also a big chunk of money (about £2.8 billion each year) goes to Local Authorities to spend on public health.  Typically they spend over half of this on sexual health and the rest on tobacco control, obesity and encouraging physical activity.   When surveyed, the public are very positive about GP services where almost 70% of them express satisfaction: this compares well to their opinions on health services at hospitals where, according to the King’s Fund, only about 60% of the public are satisfied.  At least that’s risen recently by about 5%, but paradoxically the percentage expressing dissatisfaction has also risen to about 23%.  So people’s views are polarising.  One factor that seems to make people more positive about the NHS is actual exposure to the service: older people who use the NHS more are significantly more likely to express positive sentiment about it both about GP services and hospitals.

One area where people are most positive about GPs and the NHS as a whole is that it is free.  Along with appreciation for the range of care offered and the quality of care,  people surveyed say that “free at the point of use” is one of their top three “likes”.  Of course a very high percentage of the population use exclusively free medical care – only 1.5% of health spending in the UK is private.  This is one of the lowest private health sectors in Europe and is a great contrast to the US where about half of healthcare spending is private.  But the Americans also spend a lot more on health than we Europeans.  They have a higher GDP per person but even measured as a percentage of GDP the Americans spend 16% on health while the UK spends between 8 and 9% of GDP, which of course means over 20% of all tax receipts.

So more will be spent on GP services but not vastly more and some of it will come through the local care Commissioning Groups to encourage the development of a 7-day health service.  It will be interesting to see how this affects people’s satisfaction and indeed their health.  At the moment GP practices receive a fixed lump of about £70 per patient per year which seems cheap for those who visit their GP practice regularly but expensive for those who hardly ever need medical help – but this is the nature of a publicly funded health insurance model.

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