Care Minister speech at RCGP Annual Conference 2025

And the leadership you’ve shown of the Royal College over the past three years, you’ve been a dedicated and passionate champion for your members, for the NHS and for patients both in your own Welsh community, but also right across the country. And I hope that you will stay engaged with us for the years ahead. Really looking forward to continuing to work with you.

I know that you’ve done great things in many areas, but I did want to pay special tribute to your relentless determination to reduce health inequalities.

As the front door to the NHS, it is general practice that is at the coalface of the devastation that poor health causes in the most deprived communities.

How it leaves children too sick for school, and adults too weak to work.

How these consequences play out over the course of a lifetime, and how they become entrenched in families generation after generation.

This is why closing the health gap between the richest and poorest is one of this government’s top priorities.

Because the fact that a child born in Blackpool will now live ten years fewer than a child born in Hampshire, is utterly shameful.

I know that the injustice of this postcode lottery piles ever increasing pressure on the GP practices already bearing the brunt of historic underinvestment.

The college’s own research last year found that in the poorest parts of the country, there are an extra 300 patients per GP and those of you serving in some of the most deprived parts of England receive less funding compared to practices in better off places.

This in the very areas where great healthcare is in the greatest need.

And so this government is committed to doing better by you and by everyone in our country, not just the wealthy few.

The Prime Minister promised last week a Britain built for all, and that means no longer leaving grotesque health inequalities unaddressed.

So I can confirm today that I have formally commissioned a review of the Carr Hill formula through the National Institute for Health and Care Research.

This will ensure that resources… [clapping]. Thank you.

This will ensure that resources are targeted where they are most needed, so that no practice in England is left short changed and no patient is left without care.

Now, I’ve been in this role long enough now to see the very real difference we can make to people’s lives when we come together to deliver what patients need.

And my promise to you is that this government does not and never will take your experience and expertise, nor your loyalty to our service, to our health service, and to public service for granted.

Which is why we hit the ground running from day one [political content removed].

We invested an additional £1.1 billion into general practice, the biggest increase in over a decade, and funded two above inflation pay increases.

And in one of our first decisions, Wes Streeting and I reformed the ARRS to provide you with greater flexibility and entrust you with putting together the staff your practices need.

Part of those changes included an extra £82 million. The first step to hiring an extra 2,000 GPs.

In fact, we now have the highest number of GPs on record. More than 50,000, of which about almost 40,000 are fully qualified.

And we’re increasing the number of GP training places in line with the campaign that the RCGP announced today.

That is a win for practices and a win for patients. We will not accept a situation where GPs can’t get a job and patients can’t see a GP [clapping]. Thank you.

We also swept away a swathe of meaningless and unnecessary targets, because your time is valuable and should be spent caring for patients, and we will shortly be consulting on legislation that finally recognises and honours GP status, expertise, and parity with other specialties.

Amidst all of this, patient satisfaction in general practice has gone from 61% last year to 75% this year.

You should be applauding yourself, because that is a credit to all of the hard work that you are putting in.

It shows that after more than a decade of cuts, we are putting general practice back on the road to recovery. So, thank you all very much.

Thank you for all that you have done to get us from where we were 14 months ago to where we are today.

We are moving in the right direction, step by step, and as we fix the foundations, we’re looking forward with a 10 year plan that offers a vision of the truly modern health service that you are crying out for.

One of the key enablers of our 10 year plan is the move to the Neighbourhood Health Service, which we’re clear will only work with GPs at the heart of it. Just look at the difference that so many of you are already making for patients by taking advantage of the reforms we made to the Advice and Guidance Scheme.

Figures released today show that more than half a million people have now been referred to services like dieticians, physiotherapists and sexual health experts instead of being dumped onto hospital waiting lists.

For patients, it all adds up to quicker treatment, closer to home, that’s fewer wasted journeys, fewer cancelled appointments and fewer people left in limbo.

It also frees up hospitals to focus on the most urgent cases. And it stops GP practices seeing the same patients time and time again while they wait for hospital treatment.

That is what a neighbourhood health service looks like. It is emphatically not about bringing an end to the partnership model, which we absolutely support and where it is working well, it should and it will continue.

But we’re also creating an option to work over larger geographies, leading to new neighbourhood providers with teams of skilled professionals.

We will introduce the new neighbourhood contract starting next year and arrangements for the multi neighbourhood provider will follow.

We are already making the shift from hospital to community a reality, and I firmly believe that the Neighbourhood Health Service offers a potentially game changing opportunity for GPs to shape the future of care, a future where you’re liberated from the parts of the job that you hate, the form filling and the box ticking, and you can focus on what you came into the profession to do, where you have the tools, the equipment, and the autonomy to provide world class care and where you’d be proud to treat  patients in world class facilities. Where you come in for a shift with a sense of purpose, and you go home with a sense of achievement.

That is the promise that comes with this government.

An NHS back on its feet and fit for the future.

And the stakes could not be higher. According to a survey published in the summer, half of millennials in the UK are planning to use private healthcare in the next year.

Young professionals aged 35 to 44 are increasingly opting for employment with medical insurance. Forget company cars, career progression or holidays. Nowadays, job seekers are lured by fast and easy access to a doctor and routine tests at their convenience.

That presents an existential threat to the NHS. Because if a generation of patients opt out, they will eventually ask why are they paying so much tax for a service that they no longer use?

That is the path to two tier healthcare, which would widen the health inequalities that we all want to close, and would put the future of the NHS itself at risk by turning it into a poor service for poor people.

So there is simply no getting away from the fact that we have to move with the times, and in particular, make the shift from analogue to digital.

And standardising online access and triage is a vitally important element of that shift. It is also key to our manifesto pledges to end the 8AM scramble by widening the window that patients have to request appointments, and to bringing back the family doctor by, in many cases giving patients the option to choose a specific GP when they make that online booking.

So I am really pleased that as of last financial year, 85% of PCNs said all their practices already had online consultation available for admin and clinical requests, at least for the duration of core hours.

I saw one for myself just recently the Grand Union Health Centre in Paddington, while another London surgery reduced waits from 14 days to three, with 95% percent of patients seen within a week thanks to the introduction of online facility.

They, like many practices up and down the country, have really got this cracked and they’re offering a better service to patients as a result of giving them the choice to phone up, walk in or log on.

But don’t just take my word for it.

I was delighted to read this week your support for online access, Kamila. While Doctor Joe McMannus, a GP and clinical director in Oxfordshire, calls it a game changer for staff and patients.

Doctor Duncan Gooch, chair of the Primary Care network at the NHS Confederation, said the system can and, I quote, help ensure fair access to advice and treatment, adding that many of our members are operating in this way already and have been positive about the impact.

Managing demand and providing better access reduces stress on staff, reduces conflict with patients and creates a positive environment where job satisfaction is high, he says.

I’m sure he speaks for many of you, and I’m grateful to the overwhelming majority who have enthusiastically embraced this move to modernisation.

Of course, we fully understand that there are practices which, for varying reasons, are struggling to get their systems up and running. For them, we have put in place a mix of tailored support measures available nationally, both online and directly from ICBs.

These include funding for software, peer to peer support, webinars and hands on help with workflows, staff training and processes through the General Practice Improvement Programme, which currently has 600 practices taking part.

All these tools and more are still on offer, so please do take advantage of them if you need to. But ladies and gentlemen, what I simply cannot get my head around and what we will not tolerate is the rump of refuseniks and their cheerleaders and the BMA who are intent on whipping up this issue.

And I suspect that patients are just as mystified. Here are the facts.

We negotiated and agreed a contract package in February that included the requirement to have online access available throughout core hours.

We agreed to delay the implementation by six months to give practices time to prepare. We established clear safeguards that mean GPs can divert those with urgent needs to the telephone. And we insisted that surgeries must remain fully accessible by phone and walk in.

So we are profoundly puzzled as to why this has suddenly blown up as an issue. The BMA claims that GPs are terrified. Really?

And they say the patients are at risk from an avalanche of online requests that will lead to hospital style waiting lists.

But neither of these doomsday scenarios have so far materialised.

Indeed, research recently published in the BMJ examining 10.5 million patient contacts found no evidence of supply induced demand, with practices able to tailor a care according to need, safely and with fair prioritisation.

Even the HSSIB notes that significant benefits of using online consultation tools include improved access, reduced telephone call volumes, more effective allocation of clinical time, and improved health and well-being.

So you can imagine how taken aback I was then to read one GP with 20 years experience saying, and I quote, the new system feels almost like modern day slavery.

I mean, come on, we’re asking GPs to allow patients online consultations, and of course, you’re entitled to your views on that and how it might affect your working practices.

But to suggest that it is akin to being forced into prostitution or coerced to work on a cannabis farm for zero pay and zero control over your life, that is frankly, too much and going too far.

We’re always happy to have discussions with the BMA to understand their concerns and to talk about how we can work through them together.

What we will not do is unpick the contract that we agreed with them in February, nor will we abandon modernisation and turn the NHS into a museum for 20th century healthcare.

That would be a betrayal of the patients all of us here are fighting for.

Look, I know that everything in the garden is definitely not rosy. When we said that the NHS was broken, we didn’t just mean for patients.

General Practice in particular, is still recovering from years of being underfunded, undervalued and overstretched.

But as the Secretary of State for Health has said, the NHS is hanging by a thread.

And instead of pulling on that thread, we should all be pulling in the same direction. We’re clear that the future of the NHS depends on building a health service that values GPs, invests in GPs and supports GPs.

And so we will uphold our commitment to developing a new contract within this Parliament.

Ladies and gentlemen, the truth is that for the first time in a very long time, you have a government that is on your side.

If we are to close the widening gap, expand access to primary care and catapult the NHS into the 21st century, then we need to be on the same side.

Because restoring the NHS founding promise to provide first class healthcare for everyone, whoever you are, whatever your background and wherever you live, is truly a team effort.

And only by working together as partners will we pull it off and rescue the NHS from the biggest crisis in its history.

Thank you very much.