GP Contract

Lord Kamall Excerpts

Tuesday 17th March 2026 Lords Chamber

These ideas were not cooked up by someone sat behind a desk in Whitehall. What is happening is that we are taking the best of the NHS to the rest of the NHS, working with pioneering practices that have been doing these things for a long time. Today we can see that our policies are working, and after years of decline in general practice, we are getting the front door back on its hinges. Patient satisfaction with general practice is finally moving in the right direction. According to the Office for National Statistics, almost 77% of people described contacting their GP as easy in January this year, up from just 60%, where it was languishing in July 2024. I know that when he gets up, the honourable Member for Hinckley and Bosworth, Dr Evans, will hugely welcome, as will his honourable friends, the progress that we are making”.

[Lord Kamall (Con)]

My Lords, I am grateful to the Government for this repeat. The Minister in the other place pointed to 1.3 million referrals being diverted through something called “advice and guidance”. This means that GPs must seek input from a specialist before making a referral, but some professional bodies have warned that this mandatory approach will risk creating barriers to patients accessing specialist care and may compromise patients’ safety if they are not referred in a timely manner. To address these concerns, can the Minister set out what clinical safeguards are in place where a GP believes a patient needs to be referred directly to a specialist but is instead referred to go through this advice and guidance process? If a patient comes to harm as a result of any delay due to not being referred directly to a specialist, who will bear responsibility for that decision and how will accountability be determined?

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

As the noble Lord said, we have seen 1.3 million people diverted since April 2025. Otherwise, they would have been added to the electives waiting list, in clinical terms, unnecessarily. The main thing I can say to the noble Lord on advice and guidance is that I think the figures speak for themselves. That is why we are embedding it into the core contract. We are recognising it as routine practice. It provides more predictable funding and removes annual sign-ups. More generally, I must emphasise to the noble Lord that it does not take away a GP’s right to refer. That remains a matter of clinical judgment and, as in all things, clinical judgment will rule the day.