‘We must guard against a two-tier system’, says College Chair


College Chair Professor Kamila Hawthorne appears in today’s Guardian responding to a survey by Pulse which found that nearly half of NHS GPs reported rising workloads due to patients making greater use of private healthcare services. Professor Hawthorne said:

“No patient should need to pay for care and services that they are entitled to free of charge on the NHS and we must guard against creating a two-tier system that favours those who can afford to pay and disadvantages those who can’t.

“However, with the entire NHS under pressure and the associated backlogs and long waiting times for treatment, we can understand why some patients turn to private healthcare, and why some patients feel that they are helping the NHS by paying for their treatment and thereby freeing up appointments for others.

“This survey shows the consequences if things go wrong and how this can add to the pressures on hardworking GPs and hospital staff, rather than alleviating them.

“Many private clinics pass back results to the NHS, often via general practice, to be assessed and followed up. Some private companies routinely advise clients to routinely speak with their NHS GP about their results or treatment, even when this has gone well, further adding to workload and leaving other patients facing even longer waiting times for a GP appointment.

“GPs are buckling under the strain of more than a decade of under-investment and poor workforce planning. Our teams are delivering tens of millions of appointments per month, even more than before the pandemic, but now with 883 fewer fully qualified, full-time GPs than 2019. Each GP in England is now responsible, on average, for over 2,300 patients – an increase of over 150 patients from the end of 2019 – and this is not sustainable.

“The real solution lies in greater support for the NHS, starting with investment in general practice. Our newly launched manifesto for the next General Election sets out seven steps for improving patient care and safeguarding general practice and the wider NHS.  As well as recruiting many more GPs, we are calling on all the major political parties for a fully funded national retention scheme to encourage existing GPs to remain in the profession, and measures to cut bureaucracy so that GPs can spend more time with their patients.

“Strong general practice keeps the rest of the NHS upright and will ensure that all patients can continue to receive the care they need, free at the point of need, long into the future.”

Further information

RCGP Press office: 0203 188 7659
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Notes to editors

The Royal College of General Practitioners is a network of more than 54,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.