Charges to see GP ‘will not happen on my watch’, Nesbitt says

Health Minister Mike Nesbitt has vowed that charges to access GP services will not happen on his watch.

Mr Nesbitt also told the Stormont Health Committee that he was “reasonably optimistic” a dispute with GPs in Northern Ireland over funding for services could be resolved.

The minister briefed the committee on his “Shift Left” agenda, which aims to move health services in the region towards a neighbourhood model of care.

He said there was “universal recognition” that if services continued to be delivered in the same way, “we are hurtling towards some form of collapse”.

He said: “The change has to be this almost fabled shift left.

“I know that this winter we will be inevitably be looking at our acute hospitals and the queue of sick people waiting to be treated.

“We have to shift left and try and think about prevention, in other words trying to keep healthy people healthy and when people do begin to get sick, getting in early with early prevention.

“The neighbourhood model is the way to go.”

Mr Nesbitt said GPs were central to his plans.

A vote of no confidence in Mr Nesbitt was passed by the British Medical Association’s Northern Ireland Local Medical Committee Conference in Belfast on Saturday, in response to the minister’s move to impose the 2025/26 GP contract on doctors, despite them rejecting its terms.

The additional £9 million offered by the minister as part of the contract fell far short of the extra £80 million GPs said was required to stabilise general practice services in Northern Ireland.

At the conference, delegates also voted no confidence in the Department of Health and agreed to examine options on how GPs could operate outside current NHS structures in the future.

The minister told the committee: “I am now reasonably optimistic we have the opportunity for a three-phased approach to resolving difference.

“The first will be the NIGPC (Northern Ireland general practitioners committee) will be engaging in short order with officials seeking clarity on the latest offer they have received from us.

“Phase two, they will take that back to their committee and if things go well then, if things go well we will open a new round of negotiations and discussions on a new contract.”

Mr Nesbitt added: “A small number of GPs have been talking about a hybrid model; to be clear a hybrid model means some people pay for accessing their general practice.

“Not on my watch. The tenet of the National Health Service is it is free at the point of need. I am not moving off that.

“I don’t think it is a universal view (the hybrid model), I don’t think it is anything near a universal view within primary care.”

The minister said the toughest decision he had had to make in his 18 months in the post was going back on a promise to introduce the real living wage to social care workers in September.

He said: “I would ask the committee to accept that is a sign of just how desperate the finances are and how big the gap is between what we have and what we need.”

Committee chairman Philip McGuigan said plans to shift to a neighbourhood model needed the support of GPs.

He added: “We are in a scenario where the department and GPs are currently at loggerheads over core funding.”

Mr Nesbitt responded: “Yes, the committee is in dispute with us but that has not stopped us speaking to individual GPs.

“We are having discussions about the neighbourhood model and how they see it.”