Debate contribution: Primary Care: Extreme Pressures

Debate contribution by Mr Gerry Carroll on 14 May 2024.

MLA

Mr Gerry Carroll

Party at the time

People Before Profit Alliance

Date

14 May 2024

Type

Debate contribution

Business

Private Members' Business

Heading

Primary Care: Extreme Pressures

Assembly identifier

Official Report component 4490311

Read the official Assembly record

Text

Our primary carers face an unacceptable amount of pressure without the resources to address it. While demand continues to escalate and the workforce is becoming more and more depleted, the real-terms funding cuts in general practice have created an unmanageable burden. To neglect and abandon the people who are holding up the foundation of our health service is cruel and unacceptable. The crisis has, unfortunately, been building for many years, and the necessary action to address the scenario has not been taken. It should not be surprising that the pressure has contributed to such poor retention in GP health services, with over one in 10 doctors leaving the sector in the past year. Privatisation and austerity measures have eroded the capacity of our healthcare system to function more generally. We need to look at erasing the market principles that have been forced on health services. We should stop treating GPs as business owners and let them be doctors. It would be beneficial for the Assembly to consider the Cuban healthcare model, which has the highest doctor density in the world. It focuses on the needs-based allocation of carers to communities and has a comprehensive state-backed system that does not allow an extreme financial and workload burden to be placed on its workers. It has already eradicated polio, malaria and tetanus, and I believe that it is the only country in the world that has eliminated the mother-to-child transmission of HIV. Dr Clare Wenham of the London School of Economics and Political Science asked why it is not promoted as a great case study. I suggest that, as with most things, it is probably down to politics. In a reversal of trends across the world, Cuba tends to send its doctors across the world when crises emerge, be they natural, viral or whatever. To serve a population of 11 million people, the country has 90,000 doctors. That is eight for every 1,000 citizens, which is more than double the rates in the USA and in the UK, which are 2·5 doctors per 1,000 people and 2·7 doctors per 1,000 people respectively. Cuba also has a preventative model that stops people getting ill, rather than treating them when they are unwell. We need to adopt more of that approach to stop the car at the top of the hill, rather than intervening when it has crashed at the bottom. Too often, our health system tries to play catch-up with people's health when it should intervene at a much earlier stage. We also need to talk about barriers to studying medicine and, thus, to people becoming doctors. The applicant pool for medical degrees is far too small. In 2017, the BMA reported that more than nine in every 10 medical students in the North were ex-grammar-school pupils. There is nothing wrong with that generally — I am a former grammar-school pupil — but the issue of class needs to be added into the question. The medical profession generally needs to represent the society that it serves. It cannot be the sole preserve of middle-class and upper-class kids. When university fees amount to almost £5,000 a year for four years, that basically sends a message to working-class kids that they need not apply to study medicine, and that is completely unacceptable. Recognition of our healthcare practitioners is not enough. It does not recruit and improve the retention of GPs. Our system needs complete transformation in order for them to do more than just survive the pressures of their day-to-day work. We need our Executive to supply a health budget that will mend our health service. It needs at least a 6% increase each year just to stand still, and that is completely unacceptable. GP contracts need to be addressed. We need to start to treat them as GPs and public-sector workers rather than private-sector businesses. That would take the pressure off them when it comes to insurance and other costs and would also allow care, rather than making money in some cases, to be the main factor. It would be remiss of me not to mention junior doctors as well. I believe that a motion on that is coming up next week. If we are to have a sustainable GP and healthcare sector in the months and years to come, we need to pay them what they are demanding and what they are owed.

730 words. Text as published by the Northern Ireland Assembly.

Assessment

Not flagged

Jev’s structured answers

Assessed 21 October 2026 at 10:23 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

Disagree with this assessment?

Classifications can be challenged. A person reads every challenge, and any change is recorded publicly above with its reason.

Challenge this classification