Thank you very, very much indeed for that very kind welcome.
It’s such an honour and a privilege to be here with you today, coming off the back of another quiet and uneventful week at the Department of Health and Social Care.
So it’s really good to be with you today.
Complexity – that’s a word and an idea that’s been on my mind a lot recently.
And when you look at the agenda for these two days of pulse live – stimulating and hugely varied, it’s such an insight into the complexity that you face every day.
As GPs, you don’t know who’s coming through the door with what and what it will ask of you.
It’s your ability to deal with that complexity and the needs of the person in front of you that will largely define their experience of the health system.
That responsibility and reality for you is so important to acknowledge and to honour.
So really, I wanted to start by saying thank you.
Thank you both as a representative of the government, but also just as a citizen of this country for everything that you do.
And as we look at the transformation that our healthcare system needs, complexity is our reality.
For some, it is the reason to say, no, we can’t change.
It’s all too complex.
It’s all too hard.
But we know that the complexity of the challenge itself is a call to action.
It’s a call to get started on the work that needs to be done, because delay only intensifies complexity.
And it’s also because of the scale of the mess that we inherited. [Political content redacted].
When we came into office last year, we were facing a primary care sector that was underfunded, understaffed and in crisis.
A bizarre situation where people were looking for GPs and qualified GPs were looking for jobs, and GPs were spending far too much of their time – a fifth of their working hours – in the back office pushing paper due to poor communication with secondary care.
So we are utterly committed to getting primary care back on its feet.
For every GP and for all those who need their family doctor, within weeks of coming into office, we put in place just shy of £100 million to put a thousand more GPs onto the frontline.
And in October we included GPs in the additional roles reimbursement scheme and practice.
Nurses are going to be included from April.
At the Autumn Budget, the Chancellor announced £100 million of capital for GP estate upgrades over the next financial year.
And just before Christmas, we announced an additional £889 million, which was the biggest uplift to the GP contract in years.
Now, as you all experience every day, the context of every decision matters, that we have made these choices in the context of the dire financial situation we found in July last year, hopefully tells you that we both understand the reality of general practice now, and that we are determined to change it.
So why are we so determined?
You’ve probably heard me or Wes talk about the three shifts that we need to make over the next ten years to make our health service fit for the future: from hospital to community, from sickness to prevention, and from analogue to digital.
Well, GPs are pivotal to all of those three shifts.
You sit at the heart of our NHS and you are its front door, but you’ve been neglected for far too long.
When you ask people what their top priority for the NHS is, the chances are they’ll say, fix general practice.
And from the Treasury’s point of view and the taxpayers’ point of view, a GP appointment costs around £40, whilst a visit to A&E costs up to £400.
So it is perfectly sensible to prioritise primary care as a way to relieve pressure on those parts of the service that are struggling to cope.
Now look, none of the problems in general practice are going to be fixed overnight.
We’ve taken the important first steps to fix the broken door, and you should look at all of our decisions in the context of reversing the decade long cuts to GPs as a share of the NHS total budget, and we will be, for the first time in a very long time, reversing that trend.
Our GPs are already going above and beyond, delivering more than ever, with over a million appointments a day last year, but with only a fraction more qualified GPs than there were in 2019.
So that’s why it’s been so important for us to reset our relationship, and I’m proud of the progress that we’ve made together since July.
Following extensive consultation and collaboration with the General Practitioners Committee of the BMA, the committee voted to accept the 25/26 GP contract, the first agreement in four years.
I’d like to extend my appreciation to Dr Katie Bramall-Stainer and her team for the collaborative and constructive way in which they engaged in the recent contract consultation.
We greatly appreciate their efforts and look forward to continuing this positive working relationship going into the future.
This is a fair deal for patients, the profession and the public purse.
And it’s the product of a relationship that’s built on dialogue, trust and respect.
In place of strife, we see the 25/26 GP contract as an important first step in shifting the focus of healthcare out of the hospital and into the community, and towards rebuilding general practice.
And today, we hope that GPs across the country can see our genuine intent to continue working together with GPs to build an NHS that is fit for the future.
So I want this to be a conversation today, so not a lecture.
So let me just quickly touch upon a few things that I hope will come up in our discussion.
First, moving to a neighbourhood health service.
I hope our investment and contract changes are the first steps towards broader reform.
Primary care will be the foundation of the service with GPs at its heart.
Second, bringing back the family doctor.
The new contract will support practices to identify and prioritise patients who would benefit most from continuity of care, such as those with complex and long term conditions.
And this was a pledge that was at the heart of our manifesto.
Third, cutting bureaucracy.
Back in October, we launched our Red Tape Challenge to bust bureaucracy between primary and secondary care.
We also announced that we’re bringing NHS England back into the department, to scrap duplication and to give more power and tools to local leaders and systems so they can better deliver for their local communities.
We’ve been listening closely to the sector, learning about what works and what needs to change, and we are removing 32 outdated indicators in the Quality Outcomes framework while prioritising key areas of prevention, such as cardiovascular disease.
Fourth, integration – we are reinforcing collaboration between general practice and pharmacies by improving access to records for community pharmacists to give patients more coordination of care.
Fifth, on waiting lists, we will invest up to £80 million supporting GPs to seek specialist advice before making referral, reducing unnecessary hospital visits and ensuring patients receive the right care at the right time.
We could also touch on digital.
The shift from analogue to digital must come with more online access for patients, providing parity with walk in and telephone access.
These actions reflect our commitment to securing the long term sustainability of general practice as part of a wider transformation of the NHS.
It is Change NHS.
The development of a 10 Year Health Plan that we want to be shaped by as much expertise and lived experience as humanly possible.
Change NHS is the biggest ever conversation about the NHS, with over 2,900 staff at workshops and events.
This has been a collective effort and I want to take the opportunity to thank all of our partners for running 600 events in communities across the UK to ensure those whose voices often go unheard can have their say.
We see GPs as the bedrock of the NHS and the 10 Year Health Plan.
That’s why we’re engaging with GPs online and in person, and working with the BMA to promote these opportunities to its members.
The 10 Year Health Plan represents a major opportunity for your profession to shape the next 50 years of health care in this country and beyond.
We are seeking submissions until the 14th of April, so please make sure you’ve had your say.
There’s still some time to provide your inputs and your insights.
The relationship we want with the general practice profession is bigger than just one contract.
It’s about partnership that can work through the complexity to create a system that works and delivers for the people that all of us serve.
We will keep working with you, the BMA and the wider profession to shape the future of general practice.
Moving towards a neighbourhood health service that focuses on prevention and proactive care.
It’s why I’m so grateful to have the chance to be here and speak with you today.
General practice is the front door of the NHS, so let’s fix it together. Thank you.
