The must read stories and debate in health from Thursday

Gripes over GP vision

Thursday was a big day for GPs, with NHS England’s long-awaited support package-cum-roadmap finally dropping.

The biggest headline was that NHS England said spending on general practice will increase by 14 per cent in real terms by 2020-21, with investment rising “from £9.6bn a year in 2015-16 to over £12bn a year by 2020-21”.

However, the total budgets set nationally for primary care in December – including non-GP services like dentistry and ophthalmology – are £7.7bn in 2015-16 and £9.2bn for 2020-21. HSJ asked NHS England’ for clarification on the larger figures but its spending plans are still unclear.

The General Practice Forward View has the backing of senior figures in the GP world, whose support for NHS England had waned since the Five Year Forward View came out in 2014.

As HSJ senior bureau chief Dave West points out: “Reforming primary care requires winning GPs’ hearts and minds, and the General Practice Forward View carefully avoids including material which might stoke the profession’s substantial anger and suspicion.”

But he also argues it is a flawed package – “A number of uncomfortable realities of the modernisation agenda, which are hard to sell to the profession but are nonetheless important, have been left absent from the document.”

The (potentially) neverending story

Another leak to HSJ from an insider at the British Medical Association has revealed the internal discussion between senior members of the junior doctors’ committee around whether the union should call for an indefinite strike among trainee medics.

The unprecedented action would have serious consequences for the NHS and be a further escalation of the dispute between doctors and the BMA.

The proposal was one of several options put forward last week by committee chair Johann Malawana that could be considered by the committee at its next meeting in May.

The BMA said on Thursday that no decision had been made on whether it would rule out an indefinite walkout, which would see junior doctors go on strike without a return date.

It is clear the doctors are considering all options and that is a welcome sign, but the email discussion that followed Dr Malawana’s suggestions clearly show that some members of the executive committee have no intention of negotiating with the government over Saturday pay or accepting the contract.

It may seem like an unbelievable nightmare scenario but an indefinite strike from 8 June has not been ruled out by the committee – and could well be the next step doctors feel forced to take in order to halt the government’s imposition.