Patients in hospital should get used to seeing their doctors less as the health service reaches “crunch point”, one of the UK’s top medics has warned.
In an exclusive interview before Thursday’s general election, Professor Andrew Goddard, president of the 500-year-old Royal College of Physicians, criticised both Conservatives and Labour, warning their proposals for the NHS and their “relationship to reality” meant promises were not deliverable.
In an unusually political interview, Prof Goddard said he was “frustrated” at the way the NHS had been used during the election and warned all three major parties had failed to address the looming workforce crisis among NHS doctors.
He said the number of medical students being trained in the UK needed to double to about 15,000 a year, a move that could cost the taxpayer an extra £1.5bn.
The East Midlands gastroenterologist said the increase was needed because more doctors were working part-time, while the number of patients being admitted to hospital was rising every year and a quarter of trainees leave before qualifying as a consultant.
He said: “This means we are reaching a crunch point. As a patient sitting on a ward you will see doctors less often than you did 10 years ago.
“They will be looking after more patients and being expected to turn them around in hospital much more quickly, but we are at a stage where we can’t do that anymore.”
He added: “With the increase in admissions and the reduction in beds over the past 20 years, the only reason we have managed to keep everything working is because we have reduced lengths of stay. But because the population is getting older and is more frail, that is getting harder and harder.
“Because of social care and the inability to discharge people, we are reaching stagnation.”
Asked why he was intervening during the election, Prof Goddard said: “We are a royal college and very aware of our charitable status, however, our members and fellows look to us to provide leadership when it comes to talking about the NHS.
“I would be failing as the leader of the college if we didn’t represent our viewpoint.”
He said he was frustrated “by the proposed policies and promises that are being made by both sides and their relationship to reality and what actually is deliverable”.
Labour Party proposals to train 5,000 more GPs would mean fewer doctors training in psychiatry, or emergency medicine, he warned. Equally, the Tories’ plan to have 6,000 more GPs by 2024 was not feasible without “flooding” the trainee system with overseas doctors; he also warned an increasing number of doctors were not prepared to work full time.
He said the NHS was not “up for sale” as Labour had claimed, but also expressed concern over the effect of trade deals on drug prices emphasising the Treasury should formally mitigate any increase if a trade deal delivered a net increase in money for the country but a cost to the NHS.
He said both main parties had used the NHS as a football in recent weeks adding: “It’s really hard. In my life I have voted for all three main political parties. I currently have internal conflicts on which way I will vote, there is no easy choice.
“None of the parties has thought about the long-term problems facing us.
“The promises that have been made in the manifestos are not physically possible because we don’t have enough people training to fulfil those promises. We need to think about where we want to be in 15 years’ time and plan for it now.”
Currently the NHS pays around £1.5bn to train around 7,250 doctors a year, but Prof Goddard said this should rise to 15,000 a year, a cost in excess of £3bn.
Prof Goddard, who ran the RCP’s workforce unit for five years, said the increase was doable, but added: “Do we really need a five-year course? Can we do it in four? I think we need to look at the model. The infrastructure is there.”
He added: “These are things within our grasp to understand and do something about it. The solution going forward has to be a long-term one, it can’t be done on a political cycle because that is too short term.”
He said care of NHS patients “remained of a remarkable standard” but for it to be maintained action was needed.
Prof Goddard's comments came as new analysis of official figures showed cancer patients were enduring the worst waiting times since records began.
Between April and September, for all nine national NHS cancer targets the lowest proportion of patients were treated on time since the standards were introduced a decade ago.
Targets were missed a total of 168,390 times in that period, according to Nuffield Trust and Health Foundation analysis published by The Sunday Times.
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