(Title Image: Powys Health Board)

Issues surrounding GP recruitment and the NHS workforce were raised at this week’s First Minister’s Questions. Yesterday, the Health Minister, Vaughan Gething (Lab, Cardiff S. & Penarth), provided a bit more substance.

More vacancies filled, more NHS staff than ever

Repeating what the First Minister said, the Health Minister was pleased that more people were working for the Welsh NHS than ever before. £114million will be provided in 2019-20 for workforce training, while the flagship “Train, Work, Live” recruitment campaign has successfully been deployed in a number of countries.

Psychiatry, pharmacy and general medical recruitment have also seen successful uplift in recruitment, while there were also improvements in GP recruitment:

“I am pleased to be able to confirm….that following only the first of the three recruitment rounds for GP speciality training in 2019, we have filled 131 places – 28 more doctors than at the same stage last year. I am also pleased to confirm more positive interest from doctors applying through the round 1 re-advert recruitment window in 2019, with over 50% more applications received than at this stage in 2018.”

– Health Minister, Vaughan Gething

Despite this, a review of GP training will be carried out to see if the current model was suitable in the medium to long-term.

“Too little, too late”

Darren Millar AM (Con, Clwyd West) welcomed the positive news, but it was a case of doing “too little, too late”. Between October 2015 and January 2019, 24 GP surgeries in Wales closed and 29 switched to direct management by health boards. In north Wales, 50% of eligible GP trainees have been turned away.

There was a storm brewing regarding a new GP professional indemnity insurance package too – announced by the Health Minister on Monday. It’s prompted anger from some GPs because it’ll top slice £11million from GP funding, while in England it’s a top-up.

“But this indemnity insurance scheme, which you have announced yesterday, without the backing of most GPs or their representative bodies in Wales, is very shameful indeed. You’re reducing the amount of funding that is available for GP practices here. It’s going to have a significant impact, particularly on those practices that are just about managing at the moment, and I would urge you….to reconsider your position on this….”

– Darren Millar AM

The Minister defended the indemnity scheme. It’s meant premiums won’t rise year-on-year and threaten practice finances. He also defended the proposed GP contract – still under negotiation with representative bodies – describing it as a better deal than one on offer in England.

Helen Mary Jones AM (Plaid, Mid & West Wales) criticised the poor quality of some of the data surrounding GP numbers – particularly numbers of full-time equivalent GPs. While oversubscription of GP training places was in some ways a positive, turning away so many applicants and filling just 131 training places wasn’t much to get excited about.

Lucrative agency work

While Jenny Rathbone AM (Lab, Cardiff Central) and Vikki Howells AM (Lab, Cynon Valley) praised endometriosis services and professional development respectively, Caroline Jones AM (Ind, South Wales West) warned of continued long-term recruitment challenges which weren’t necessarily restricted to Wales:

“Even if you meet your recruitment targets, many of the royal colleges….warn it’ll be insufficient. So, what discussions have you had with (representative bodies) about ensuring safe staffing levels over the coming decade? Bear in mind that many nurses find agency work extremely lucrative, and one mentioned to me that in 2.5 days she can earn a week’s salary. Many GPs are turning to part-time work, some because of the stress of working full-time and others due to family commitments”

– Caroline Jones AM

The Minister said GP practices are likely to be very different places in the future and possibly fewer in number; “single-handed practices” (as he described them) aren’t sustainable. There’s also the Nursing Levels Bill introduced during the Fourth Assembly which is yet to be rolled out.