GPs should be banned from jobs in affluent areas, think tank report says 


GPs in affluent parts of England could be forced to work in deprived areas in a bid to address health inequalities under plans being considered by ministers. 

A report by the Social Market Foundation think-tank found the poorest places have just half the number of trained doctors per head compared to the richest.

It called for a new regulator to be set up which would decide where GPs can open practices so that access is more evenly spread around the country.

The report goes on to stress that the need to close this gap is an essential part of Boris Johnson’s levelling-up agenda.

Health Secretary Sajid Javid has also pledged to tackle the ‘disease of disparity’ that causes poorer people to die almost a decade earlier than the richest.

Figures show there is one full-time GP for every 2,289 patients nationwide, which has been becoming wider for decades.  

In Blackpool North the ratio is 4,480 patients for each full-time GP, compared to one GP per 1,688 patients in Oxfordshire and 1,731 patients in West Suffolk.

It comes amid a furious row between GPs and Mr Javid over a lack of face-to-face appointments. Nationally, family doctors are currently seeing a fifth fewer patients in-person now than before the pandemic.

GPs could be forced to work in deprived towns in a bid to close the gap with more affluent areas under government plans, according to a new report from the Social Market Foundation

Some four in ten appointments are still not being carried out face-to-face, figures showed. The above graph shows the proportion of appointments that have been face-to-face since September two years ago

Some four in ten appointments are still not being carried out face-to-face, figures showed. The above graph shows the proportion of appointments that have been face-to-face since September two years ago

Experts have called for the return of a body called the Medical Practices committee which had the power to refuse new GPs’ applications in areas that already had a sufficient number of doctors in a bid to level-up healthcare in poor parts of the country.

John Gooderham, a former secretary to the Medical Practices committee, which was abolished under Tony Blair’s premiership, has said a similar practice should be reinstalled to help prevent areas from being ‘under-doctored’.

In an essay for the Social Market Foundation, he wrote: ‘Deprived areas are being worst affected by shortages of GPs. That trend is increasing, and is widening health inequalities.

‘Where GPs work should no longer be left entirely to market forces, as has happened for the past 20 years.’

Mr Gooderham does not want to see GPs being told where they must work as this would be ‘strongly opposed’.

But he said having the option of restricting where GPs could work, even if this is never put into practice, is less draconian. 

Here are the top 15 countries where overseas trained GPs got their original qualification. India accounts for the vast majority of these overseas trained GPs, accounting for one in three, followed by Pakistan and Nigeria. Ireland and Germany are biggest EU contributors to overseas trained GPs in England

Here are the top 15 countries where overseas trained GPs got their original qualification. India accounts for the vast majority of these overseas trained GPs, accounting for one in three, followed by Pakistan and Nigeria. Ireland and Germany are biggest EU contributors to overseas trained GPs in England

This map shows the percentage of GPs in each Clinical Commissioning Group in England which originally trained overseas. The nationwide total of foreign trained GPs is 20 per cent, but there is massive regional variance. Some areas have recorded more than half of their GPs as having got their original qualification from a non-British nation

This map shows the percentage of GPs in each Clinical Commissioning Group in England which originally trained overseas. The nationwide total of foreign trained GPs is 20 per cent, but there is massive regional variance. Some areas have recorded more than half of their GPs as having got their original qualification from a non-British nation

Up to 70% of GPs in parts of England were trained abroad Britain, NHS figures show

Two thirds of GPs serving some parts of England originally trained outside the UK, official figures show amid calls for the country to become more ‘self-sufficient’.

Nationally, one in five GPs across England originally qualified overseas, but there is massive variance in how these family doctors are distributed across the country.

MailOnline analysis of NHS data from September this year found that in areas like Thurrock in Essex, 67 per cent of GPs serving patients originally trained abroad.

Other Clinical Commissioning Groups where foreign trained GPs made up at least half the area’s doctors included, North Lincolnshire (54.9 per cent), Southend in Essex (54.4 per cent), Cannock Chase in Staffordshire (52.5 per cent), Stoke on Trent (51.9 per cent), and Castle Point and Rochford (50 per cent). 

Most of England’s overseas trained GPs got their original qualification in India, accounting for one in three of this group of doctors, NHS data shows. Pakistan and Nigeria both made up around 10 per cent, respectively. 

The latest data follows Health Secretary Sajid Javid’s admission that the Government would fail in its objective to recruit 6,000 more GPs in England by 2024.

There have been calls for the Government to loosen Brexit rules and allow more foreign doctors to come to the UK to plug the workforce crisis but others have said ministers need to do more to nurture UK-born students. Although, campaigners accept that the country needs as many GP as it can get.

He added: ‘A GP would realise they wouldn’t be allowed to work in that over-doctored area, and would decide to work somewhere that was under-doctored instead.’

Currently, the NHS is using £20,000 bonuses in a bid to encourage new GPs to move to areas that are under-doctored.

But the Government is lagging behind on its target of 6,000 more GPs by 2024, according to Sajid Javid.

James Kirkup, director of the Social Market Foundation, said: ‘Anyone who wants to level up the country should address this by getting more doctors to work where they’re most needed.’

Tensions between the nation’s GPs and Government are already running hot due to a row over face-to-face appointments.

Mr Javid has threatened to name and shame practices that fail to see enough patients in person.

Doctors have threatened to strike over the proposals, warning that they are overwhelmed with the backlog of care following the pandemic.

They also say that many patients prefer to be seen virtually because it is more convenient to them.

But anecdotally there have been reports of elderly patients being denied access to a doctor. 

Figures show that around six in 10 GP appointments are in-person now compared to more than 80 per cent before Covid. 

The feud escalated further last week with Mr Javid stating patients are resorting to turning up to overwhelmed emergency departments because they can’t access a doctor in person.

Mr Javid made the comments to MPs from the Commons Health and Social Care Committee.

‘[A] significant portion of people are turning up for emergency care when they could have actually gone to their GP.

‘That is not the fault of those people at all. They have stayed away from the NHS when they were asked to, they now want to be seen and that is right.

‘But part of the reason I think people are turning up in A&E perhaps when they don’t need it is because they’re not able to get through to their primary care services in the usual way.’

Asked again if a lack of availability of GP appointments had led to increased pressure on A&E, he said: ‘I think that that general point is correct.’

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