General election 2017: Tough choices for London’s NHS

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The simple statistics for the NHS in London make stark reading as well as also tell you why trying to sort the item out as well as also protect the item for the future is actually both incredibly important as well as also extremely challenging.

Every year inside capital:

  • There are 60 million GP consultations – which’s about 165,000 every single day
  • The NHS spends nearly £18bn
  • There are currently up to 8,000 GPs in about 1,400 practices
  • There are 60,000 nurses across the NHS, local authorities as well as also voluntary sector
  • In 2016-17 there were 1,040,128 elective operations reported in London

They are big numbers which require big solutions, along which has a big dose of political support. nevertheless change of which scale could be hard to deliver.

Ten years ago there was a plan to change the way the NHS worked in London, with greater focus put on primary care rather than hospitals.

Sound familiar?

Called “A Framework for Action”, the item was a plan which delivered some big improvements in London with particular success inside fresh major trauma units as well as also the fresh specialist stroke centres.

the item also promised 100 fresh so called “polyclinics” to offer a range of services through fresh buildings.

nevertheless the strategy was ditched when the coalition government came to power in 2010.

David Cameron’s government had its own plan, which promised a boost for local GP services as well as also a move to more care out of hospital.

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Today the arguments remain pretty much the same.

There is actually wide agreement more care needs to be delivered closer to home as well as also more resources need to be funnelled to primary care as well as also GPs.

Experts say a shift is actually needed to a proper National Health Service which keeps people well as well as also away through a national illness service, which picks up the pieces when they become unwell.

nevertheless how do you get there? Change inside NHS is actually expensive as well as also also politically difficult.

Moving or cutting services at hospitals for example is actually often deeply unpopular.

Promises made at elections can make you look opportunistic some years later.

Campaigners at Chase Farm Hospital in Enfield, north London, will remember David Cameron promising to keep their A&E open before the 2010 election. the item is actually today closed.

Services across the capital are currently being reviewed under a process known as Sustainability as well as also Transformation Plans, which assess how the NHS will look over the next a few years.

There are a few of these as well as also all involve moving services around, while some involve the closure or downgrading of A&Es.

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All involve plans to save millions inside way services are delivered while also spending millions on fresh buildings as well as also different services.

All say which doing nothing is actually not an option. If the NHS continues to spend inside way the item is actually as well as also deliver services inside way the item does today, the item will face a funding shortfall of more than £4bn in London alone.

If re-arranging hospital services is actually a challenge, the one facing primary care is actually just as hard. Shifting the focus to getting patients treated by GPs means finding doctors to deliver which service.

A recent survey by the Londonwide Local Medical Committees, showed 42% of practices had a GP or practice nurse vacancy, while 45% of practices had a GP who was planning to retire inside next three years.

In fact, NHS statistics show the city has the highest number of GPs over the age of 55.

“The situation is actually worse than I’ve ever seen the item”

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Media captionWillesden GP Dr Adrian Richardson: “2016 was the worst year of my clinical life.”

Willesden GP Dr Adrian Richardson knows the pressures only too well.

His practice nearly closed last year, as three of its partners left, either retiring or choosing to get out of general practice.

“the item’s sad the situation in which practice was which people felt which options were better outside the practice than in,” he said.

“I stayed because I didn’t feel the item was right to leave 15,000 patients without a proper practice.”

He blames increasing workloads as well as also paperwork for the extra pressures.

“The situation is actually worse than I’ve ever seen the item.

“If you ask me about 2016 the item will go down as the worst year of my clinical life.”

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All the parties are committing to recruiting more GPs as well as also nurses nevertheless doing the item quickly is actually not possible, given the length of time the item takes to train them.

All the parties are promising more money for the NHS as well as also social care. There are promises too of more money for fresh buildings as well as also pledges to rebuild an ageing estate.

There are promises which may be viewed with some scepticism through those working inside NHS as well as also certainly shared by the Nuffield Trust think tank which specialises in analysing health policy.

the item said: “Promises of billions extra for the health service can sound like big sums … unpicking the pledges through each of the manifestos reveals which the NHS looks set to face a further a few years of austerity, whoever forms the next government.

“Whichever party forms the next government will have to face some tough decisions about the future shape of the health service, as well as also how the item can continue to meet the needs as well as also expectations of its patients as well as also staff.”

Hard choices on the NHS lie ahead for whoever wins the election.

What’s on offer through the party manifestos:


  • Commit to over £30bn in extra funding over the next parliament through increasing income tax for the highest 5% of earners as well as also by increasing tax on private medical insurance
  • Boost capital funding for the NHS, to ensure which patients are cared for in buildings as well as also using equipment which is actually fit for the 21st Century
  • Halt as well as also review the NHS Sustainability as well as also Transformation Plans as well as also ask local people to participate inside redrawing of plans which has a focus on patient need rather than available finances


  • Ensure the NHS has the buildings as well as also technology the item needs to deliver care properly as well as also efficiently
  • Increase NHS spending by a minimum of £8bn in real terms over the next a few years, delivering an increase in real funding per head of the population for every year of the parliament
  • Ensure the NHS as well as also social care system possess the nurses, midwives, doctors, carers as well as also additional health professionals which the item needs

Lib Dems:

  • An immediate 1p rise on the basic, higher as well as also additional rates of income tax to raise £6bn additional revenue to be spent only on NHS as well as also social care services
  • Direct additional investment to priority areas inside health as well as also care system including social care, primary care as well as also additional out-of-hospital care, mental health as well as also public health
  • inside longer term as well as also as a replacement for the 1p income tax rise, commission the development of a dedicated Health as well as also Care Tax on the basis of wide consultation, possibly based on a reform of National Insurance contributions


  • Close the NHS spending gap as well as also provide an immediate cash injection to ensure everyone can access a GP, hospitals can run properly, as well as also staff are fairly paid
  • Scrap the NHS Sustainability as well as also Transformation Plans
  • Roll back the privatisation of the NHS


  • Provide NHS England with an extra £9 billion a year by 2021/22
  • Launch the toughest ever crackdown on ineligible foreign nationals using the NHS

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