Martin Wrigley

I beg to move, That this House has considered GP funding in the South West. It is a pleasure to serve under your chairship, Dame Siobhain. GPs are the front door of the NHS. They diagnose and treat illness, prevent disease and provide vital mental health support. As Lord Darzi once observed, general practice displays “the best financial discipline” in the NHS family while constantly innovating to keep patients out of hospital. However, GP funding is complex, obscure and insufficient. The bottom line is that the amount of money GPs receive is insufficient to deliver the obligations they carry. That is a view held by every single one of the 28 practice managers I met in and around my district, who tell me the situation is unfunded, unsustainable and unsafe. GP funding is broadly based on two elements: a so-called global sum for core service costs, and additional quality and outcomes framework payments. The global sum starts with a payment per patient per year of £121.79—that is less than we might pay for our dog to go to the vet for an annual check-up, or about a third of the cost of servicing a Renault Megane. It is no wonder that practice managers spend their evenings juggling spreadsheets simply to keep the lights on. It gets worse. That paltry sum is then modified by something known as the Carr-Hill formula. Carr-Hill was designed for a different era. It weighs patient numbers and postcodes but underrates deprivation, multimorbidity and today’s population health priorities. The consequences are stark and deliver what is known as the inverse care law. In my constituency, the Buckland surgery looks after some 4,000 patients on its list but is effectively funded for 3,200.