Sajid Javid, the Secretary of State for Health and Social Care, is right to highlight the importance of the booster jab programme. But accelerating this rollout by reducing GPs’ other workload, lessening the pressure to hold more in-person consultations, or even offering them financial inducements to give out more vaccinations, would be bad for patients and for society.

That won’t have stopped it being music to the ears of Dr Farah Jameel, the newly appointed chair of the British Medical Association’s GP committee, because you can be sure that any reduction in workload will never be reversed and will simply become the new norm for future negotiations. 

In October, Mr Javid announced a £250 million boost for GP practices to improve patient care. There were some reasonable conditions attached, for example: GPs who refused to provide more face-to face appointments were to be named and the highest earning GPs would be asked to declare their income.

The BMA dubbed it a “bully’s charter” and, despite government concessions, announced an indicative ballot on industrial action, the result of which is expected soon. At the time, the chair of the BMA’s GP committee was Dr Richard Vautrey, considered a hard-liner but who resigned when the committee demanded an even tougher stand against the Government. Dr Jameel was rapidly elected.

Previously, Dr Jameel has said that GPs should be paid extra for performing what she regards as non-core work. The examples she gave were doing a simple lung function test (spirometry), which takes seconds, and taking out stitches, which is usually done by the practice nurse. These are tasks that most GPs would regard as a routine part of the job. The already militant BMA is getting more inflexible.

Rolling out booster jabs is, of course, important, but anything that threatens to restrict GP services further is a dangerous policy to follow. What about the cancer backlog? Only this week it was estimated by the National Audit Office that three quarters of a million cancer referrals had been missed during the pandemic. Diagnosing cancer early is essential to improving survival and any delay will inevitably result in more advanced disease and lower cure rates.

Many of the most vulnerable have, mercifully, already had their third jab. It seems especially perverse to suggest that it is better for GPs to spend their time giving boosters to younger, healthier cohorts than seeing patients who may be in desperate need.

It is not entirely clear that we even need GPs to give out jabs at all. After December 2020, when the country was put on a vaccination “war footing”, clinics were set up in pharmacies, church halls, council buildings and even car parks, manned by volunteers, especially nurses and medical students. Almost 12,000 retired doctors were given temporary registration by the General Medical Council. Surely such an arrangement could be repeated.

Meanwhile, A&E departments are overwhelmed by patients desperate for urgent care, often because they cannot see a GP. Why? Writing this off as simply being down to the pandemic, as many would have us do, ignores far deeper issues, the worst of which is the way that part-time working has become endemic within general practice. This is the fundamental problem afflicting primary care and its corrosive, fragmenting effect on patients is never mentioned by the BMA, the Royal College of GPs or, indeed, by government ministers.

By my estimate, as many as 70 or 80 per cent of GPs are working part-time. If part-timers temporarily worked a few more sessions, possibly paid for from Javid’s £250 million, then the post-Covid problem of access to GPs would be solved. Why, in the interests of public health, have the GP representatives not suggested this?

We face two converging problems: the need for mass vaccination, and the urgency of identifying missed cancers and other conditions. One of these problems cannot be sacrificed to solve the other. We must succeed with both. Sadly, the inability or unwillingness of GPs to countenance change is making failure more likely.

J Meirion Thomas is a consultant surgeon