Dave Duffy offers his thoughts on the immediate health priority for the government.

‘The NHS is broken’. It’s a view we’ve all heard countless times over the past few years. But if it’s broken, what specifically needs fixing and how do we fix it? These questions are some of the most challenging facing the new Labour government, and it will be fascinating to see what the NHS looks like at the end of this parliament compared with its current state.

Many of us working in a clinical setting, however, share a view that there’s one ‘lever’ the new government could pull to make a bigger impact than any other.

Managing the ‘front door’

Primary care and GP practice are the front doors to the NHS. If we want to reduce the pressure on other areas – in secondary care and hospitals — we have to manage the front door and give primary care the investment it needs.

I see it as a positive sign, then, that the Labour government appears to have recognised this, with a manifesto pledge to invest in general practice, but it’s vital that the pledge comes with a joined-up plan for delivery.

I’m not the only one to feel that way. Speaking about Labour’s election manifesto, Professor Philip Banfield, council chair of the BMA said:

“Promises to train more doctors, including ‘thousands’ more in general practice, also need backing with positions throughout the training pathway, and jobs to go to once they qualify. We have a situation where newly-qualified GPs are left jobless because practices aren’t funded to, and therefore can’t afford to, take them on. The current situation where funding has been blocked from being used to employ doctors has to stop.”

As ever, the devil of Labour’s commitment will be in the detail, but it’s encouraging to see that government and the medical profession at least share a similar view of priorities and the direction of travel.

Making progress with elective surgery waiting lists

As much of a step forward as primary care improvements would be, we can expect the elective surgery landscape to remain extremely challenging. Demand for elective surgery such as knee replacement continues to increase, and studies like this one have found the UK’s post-Covid recovery for major surgery has compounded the issue.

There is no easy solution to this, but better prevention, optimising non-surgical treatment paths and managing people outside of hospital has to be the answer as long as capacity remains so tight.

We do see patients who view knee replacement as the first and only answer to their knee pain. Yet there are often things they can do to alleviate that pain. There are behaviours they may be able to modify and elements they could reverse without surgery. It’s an educational challenge as much as anything, but if we can reach a point where both patients and clinicians understand that knee replacement is the right option only once non-surgical approaches have been exhausted, we may, in combination with other initiatives, be able to give the NHS the breathing space it needs.

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