Debate contribution: GP Services: South Antrim
Debate contribution by Mrs Pam Cameron on .
- MLA
- Mrs Pam Cameron
- Party at the time
- Democratic Unionist Party
- Date
- 10 February 2026
- Type
- Debate contribution
- Business
- Adjournment
- Heading
- GP Services: South Antrim
- Assembly identifier
- Official Report component 5436004
Read the official Assembly record
Text
Thank you, Mr Speaker. This Adjournment topic focuses specifically on GP access in South Antrim, but every Member will recognise that this issue affects the whole of Northern Ireland. No constituency is untouched by the pressures facing general practice, and no family is unaffected by the growing difficulty in securing timely GP care. The recent report from the Public Accounts Committee (PAC) has laid bare the scale of public concern. More than 15,000 people responded to its call for evidence, and over half rated their experience of accessing GP services as poor. Many described spending long periods on hold, repeatedly calling or being advised to try again the next day. Some patients turned to private provision or emergency departments, not out of choice but because they felt that they had nowhere else to go. The Committee also heard that the Department does not hold complete full-time-equivalent GP workforce data, which is a basic requirement for any modern health system that seeks to plan sustainably. At the same time, we know that the number of GP practices has fallen over the past decade while demand has risen. As of March 2025, Northern Ireland had just over 305 GP practices, supporting just over two million people. That represents a 13% reduction in practice numbers, despite a significant increase in population. Average list sizes have risen by more than 23%. That imbalance between capacity and demand is the foundation of the many difficulties that we see today. The pressures are even more evident in rapidly developing areas. According to the 2021 census data, in 10 years, the population of Ballyclare has grown by around 8·5%, and the population of Antrim has grown by around 9%. Those growth patterns reflect extensive new housing and expanding commuter communities, but GP capacity has not increased in tandem. Surgery teams are now attempting to support thousands more residents without the corresponding infrastructure, staffing or investment. Behind those figures are, of course, real people. One constituent stated that, after hospital clinicians advised that they urgently needed medication, their GP practice did not have the staffing capacity to issue the prescription, which meant that they had to return to hospital simply to obtain that medication. Others described being unable to access their practice because they could not sit on hold at 8.30 am, including teachers, who cannot leave classrooms; carers, who cannot abandon those whom they support; and shift workers, who cannot walk away from their duties. One parent told me that they spent an entire morning phoning repeatedly for their unwell child, with no queue system and no callback function. After losing a day's pay, they ended up in their local GP out-of-hours service. Others described delays in follow-up after photo-based assessment, with at least one person's condition worsening significantly overnight.
We know that extended waits for specialist consultants are also pushing patients back into general practice for interim reviews, pain management, sick lines and monitoring that should be taking place in secondary care. Long delays in key areas, including pain services and hip and knee replacements, are forcing people to return repeatedly to their GPs, while they are living in significant discomfort and pain with reduced mobility and a loss of independence. Those prolonged waits are also driving economic inactivity, as people remain unable to work at times, while they wait for their procedures and treatments. It is important to recognise that not all the feedback was negative. Some patients shared very positive experiences of being seen promptly and being treated with genuine compassion by their GP practice. Those examples remind us that, despite immense pressure, many GP teams continue to provide excellent care every single day. I also want to be clear about the perception around these issues. The concerns that people have shared with me about access are, of course, real. They are valid and deeply felt. But it is equally true that, when people succeed in getting through and are seen, they describe the care that they receive as professional, compassionate and of a very high standard. My point is not to minimise anyone's frustration — far from it — but simply to say that, if the wider conversation continually paints general practice as being beyond repair, we risk discouraging some people from seeking the help that they genuinely need in the first place. We must address the problems of access whilst recognising the dedication of the staff who continue to deliver high-quality care under immense pressure. Goodwill alone cannot sustain a system under this level of strain. Much of the GP workload is unseen: reviewing blood tests and imaging, chronic disease management, follow-up hospital letters, safeguarding responsibilities, palliative care support, supervising trainees, visiting care homes, supporting social care teams, dealing with prescription shortages and liaising with pharmacists, district nurses and allied health professionals. That is the clinical engine room of the NHS, and it is running beyond capacity. I also want to touch on community pharmacy, because it is clearly a vital part of the primary care system. Pharmacies remained accessible throughout COVID and the successive winter pressures. With the appropriate support, they can relieve pressure from GPs by expanding Pharmacy First, supporting repeat prescription management and continuing their important vaccination and prevention work. However, pharmacy itself must be stabilised if it is to take on more, particularly in the light of the medicine supply pressures and financial challenges. One of the gravest ongoing risks is the rise in GP contract hand-backs. When a practice reaches the point where it cannot continue, patients are dispersed into neighbouring practices whose lists are already overstretched. That is deeply destabilising and can create a domino effect across an entire locality. Although South Antrim has not yet seen the same level of contract collapse as other areas, the pressures are similar and the risk is real. We cannot, of course, ignore the age profile of our GP workforce. While GPs are of a similar generation and are approaching retirement around the same time, others are burning out under the weight of the current workload, and the pipeline coming behind them is perhaps not large enough to replace those who will leave the service. Without urgent stabilisation, contract hand-backs could escalate sharply as practices lose the experienced clinicians who have held the system together for years. We must remember that GPs and their staff are human, just like the rest of us. They have lives, families, good health, ill health, mental health issues and the same pressures that we all face on a day-to-day basis. They are doing their best under immense pressure. I have also heard of completely unacceptable instances of verbal abuse being directed at GPs and their practice staff. Such abuse may be born out of frustration, but it is wrong and harmful nonetheless. No workforce can withstand that level of strain without consequences for morale, retention and well-being.
The challenge is made more concerning by the fact that future recruitment is also at risk. During my discussions with GPs and the BMA, I was told that they had held a round table with medical students at Queen's University. Those students were asked whether they would consider a career in general practice, and a large percentage said that they would not. That should alarm us all. I am glad to see the Minister of Health with us this afternoon. I very much appreciate his time; he is a busy man. Minister, do you believe that we have sufficient numbers of new GPs to come forward to replace those who are due to retire or leave the service? If not, what plans are in place to address that gap? The emerging neighbourhood model aims to provide more care within the community and to reduce unnecessary hospital reliance. That, of course, is the right direction of travel, but it is achievable only if GP practices are supported to deliver more neighbourhood-level work, including in care and residential homes. Trusts may need to redirect parts of their budgets into community-based services. If so, that must be done clearly, fairly and consistently. If resourced properly, the shift-left model would help to reduce avoidable attendances at emergency departments by ensuring that more people are treated safely earlier and within the community. Multidisciplinary teams (MDTs) have also shown real value where they exist, bringing physiotherapists, mental health practitioners, pharmacists and social prescribing link workers directly into practices. However, MDT roll-out has been unequal. Some areas benefit from full coverage, while others have little or no MDT provision. That inequality must be resolved. Funding sits at the heart of all of it. Health receives more than half of the entire Executive Budget, yet general practice receives the lowest share of any UK nation at around 5·4% or roughly £450 million. GP representatives asked for an additional 1% — around £80 million — of the Health budget to stabilise the service; instead, practices received an uplift equivalent to roughly 50p per patient. Understandably, that was deeply frustrating for GPs, particularly when negotiations stalled and the contract was ultimately imposed. I am encouraged that GP representatives and the Department have since returned to discussions, and, while we are not privy to those conversations, I hope that they lead to a fair and timely resolution that restores stability to general practice. The single greatest source of frustration for many patients remains at the 8.30 am bottleneck. People want a system that does not require them to sit on hold, lose wages or rearrange caring responsibilities just to secure a GP appointment. Modern telephony, queuing systems, callbacks, digital pathways with non-digital alternatives and staggered appointment releases are all essential steps forward. Practices stand ready to play their part, of course, but they need the tools, the workforce and the investment to deliver change. The debate is not about blame: it is about acknowledging the pressures, recognising the experiences of the public and supporting the work needed to build a fair, sustainable and patient-centred primary care system. General practice is the foundation of our health service. If it is strengthened and stabilised, every other part of the system benefits. If it continues to be stretched beyond safe limits, every part of the system suffers. I place on record my thanks to all the constituents who got in touch with me with their feedback and experiences of GP access in South Antrim and to the GPs and BMA representatives who met me ahead of the debate to share their insights and concerns. Their contributions have been invaluable to the debate.
1,752 words. Text as published by the Northern Ireland Assembly.
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