20 June 2019 — WSWS
Research from the Pulse GP news website reveals that the rate of General Practitioners (GP) surgery closures in the UK has increased eightfold since 2013.
In 2013, 18 GP surgeries closed in the UK, while in 2018, the number of closures soared to 138. Over the past six years, 583 surgeries have closed and dozens more are set to close throughout 2019. January of this year saw 12 closing (compared with 8 in the same period the previous year), according to data from a Freedom of Information (FOI) request by Pulse .
The closures include full practice closures, branch closures and mergers of surgeries, which have impacted over 1.4 million patients. The data also reveals that 86 percent of the practices that closed in 2018 affected fewer than 5,000 patients—highlighting that it is the smaller practices that are being hit, many in the remote, and hard-to-reach areas of the country. The number of patients having to change GP surgeries last year was as high as 519,000.
The information was captured by issuing FOI requests to all the 217 National Health Service (NHS) clinical commissioning groups (CCGs) and the equivalent health boards in Wales, Scotland and Northern Ireland, with 186 responding to the requests.
The report of the GP closures, carried by Sky News , highlighted some of the regions hit hardest by the closures:
* 61,973 patients affected in North Hampshire
* 29,476 patients affected in Newport (Aneurin Bevan University Health Board)
* 21,594 patients affected in north Wales (Betsi Cadwaladr University Health Board)
* 20,591 patients affected in Ipswich and East Suffolk
* 16,422 patients affected in Walsall
The revelations come less than a year after the Royal College of General Practitioners revealed that one in three GPs were thinking of quitting within five years. This was corroborated by a joint report issued by the Nuffield Trust, the Health Foundation and the King’s Trust, suggesting that 7,000 GPs would be leaving the health care profession in the next five years. This report suggested that £900 million in funding would help reverse the high number of nursing vacancies, while claiming that the gulf in GPs “cannot be filled at all.”
The GP closures are symbolic of the catastrophic state of the NHS after almost a decade of continual cuts and deprivation. The closures expose government claims that the decline in surgeries is due primarily to a decline in the number of qualified GPs.
According to The Independent, “GP leaders said that closures were typically a last resort, where the loss of other partners had left one doctor unable to recruit full-time staff and no way to maintain safe care.”
“The system is creaking,” stated Dr. Jackie Applebee, chair of Tower Hamlets medical committee, “Smaller practices—which patients prefer and which have good outcomes—are being lost because of the under-resourcing.”
Professor Helen Stokes-Lampard, chair of the Royal College of General Practitioners, declared, “when a practice closes because resource and workforce pressures mean that it is no longer safe or sustainable to keep running, it’s incredibly serious.”
Figures released by NHS Digital confirm these assessments, showing a drop of 441 GPs since March 2018. NHS England countered with the claim that the figures would be up by 312 GPs if those in training were included. However, that doesn’t even account for those leaving before the trainee GPs are fully qualified.
NHS England also claims that the “resilience fund”—set up in 2015 to try to plug the hemorrhaging of more NHS staff—is ensuring the retention of valuable staff, but this is belied by the reality of the situation.
The UK government’s pledge to recruit 5,000 GPs by 2020 also looks set to fail.
Despite the rhetoric earlier this year with the launch of the Tories’ 10-year Long Term Plan (LTP) to “save” the NHS—having spent the previous decade butchering it—this is all in keeping with the real aims of the British ruling elite: the carve-up and sell-off of the UK’s largest public “asset” to private investors in Britain and internationally.
This was made clear during the recent state visit to the UK by US President Donald Trump, who declared, “When you’re dealing in trade, everything’s on the table, so NHS or anything else, or a lot more than that, but everything will be on the table, absolutely.”
Trump had to subsequently backtrack due to the hostility of the UK population to the mass sell-off of the NHS to US corporations, with his allies in the ruling Conservative Party no doubt telling him that such bald statements in relation to the NHS cannot be made in public without risking electoral damage.
Trump’s visit came barely a month after a leaked letter revealed that NHS England is looking to see “provider collaborators” covering “children and adolescent mental health inpatient services, adult secure mental health services, and adult eating disorder services. … It is our expectation that people with learning disabilities and/or autism are included in the population served by the provider collaborative.” The letter makes clear that these “provider collaborators” will cover 75 percent of the country’s services by April 2020 and up to 100 percent by 2022.
The invite for “high level” applications is an open market for an approximate budget of £2 billion annually to cover mental health services. According to the Health Service Journal, the supposed impetus for leaking the letter authored by Stephen Firn—the new care model’s programme director—is the failure of NHS England to meet its target to move 35 to 50 percent of learning disabilities and autism inpatients out of hospital beds and into community accommodation by March 2019.
The “provider collaborators” are none other than the Integrated Care Systems (ICSs), which were born out of the Tories’ LTP. As the WSWS noted on the announcement of the LTP, “Every ICS will work towards an ‘Integrated Provider Contract’ and these contracts will no doubt be awarded to or sub-contracted to the private sector.”
The only way to counter the wholesale privatisation of the NHS is the mobilisation of health care workers in the UK and internationally against the destructive policies of the ruling class, based on a revolutionary socialist perspective.
The last year and a half has seen a massive resurgence of class struggle, including teachers’ strikes in the US, the maquiladora workers’ strikes in Mexico, the “yellow vest” protests in France, Russian health care workers’ protests, and most recently, the strikes against the military regime in Sudan and the mass protests in Hong Kong.
We urge health workers to contact NHS FightBack, initiated by the Socialist Equality Party, to discuss the building of rank-and-file committees, independent of the trade unions. On this basis, a powerful joint offensive can be established of NHS workers, local government staff, education workers and employees throughout the public and private sector in defence of jobs, wages and essential services.