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Patients in hospital should get used to seeing their doctors less as the health service reaches “crunch point”, one of the UK’s top medics has warned.
In an exclusive interview before Thursday’s general election, Professor Andrew Goddard, president of the 500-year-old Royal College of Physicians , criticised both Conservatives and Labour, warning their proposals for the NHS and their “relationship to reality” meant promises were not deliverable.
In an unusually political interview, Prof Goddard said he was “frustrated” at the way the NHS had been used during the election and warned all three major parties had failed to address the looming workforce crisis among NHS doctors.
He said the number of medical students being trained in the UK needed to double to about 15,000 a year, a move that could cost the taxpayer an extra £1.5bn.
The East Midlands gastroenterologist said the increase was needed because more doctors were working part-time, while the number of patients being admitted to hospital was rising every year and a quarter of trainees leave before qualifying as a consultant.
General election: On the campaign trailShow all 114 1 /114General election: On the campaign trail General election: On the campaign trail Boris Johnson drives a Union flag-themed JCB, with the words "Get Brexit Done" inside the digger bucket, through a fake wall emblazoned with the word "GRIDLOCK", during a general election campaign event at JCB construction company in Uttoxeter, Staffordshire
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General election: On the campaign trail A sculpture of an owl is bedecked with an EU beret as Liberal Democrat leader Jo Swinson gestures during an interview at a general election campaign event in Bath
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General election: On the campaign trail Boris Johnson (C) talks during a question and answer session on a general election campaign visit to Ferguson's Transport in the town of Washington, west of Sunderland
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General election: On the campaign trail Boris Johnson tries to save a shot during a warm up before a girls football match while on the campaign trail in Cheadle Hulme, northwest England
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General election: On the campaign trail Jeremy Corbyn makes cup of coffee as he campaigns in Barry, south Wales
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General election: On the campaign trail Nicola Sturgeon poses as she launches the SNP campaign bus tour, at Queensferry Crossing in Edinburgh, Scotland
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General election: On the campaign trail Boris Johnson reacts as he changes a wheel of a Formula One car during a Conservative Party general election campaign visit to Red Bull Racing in Milton Keynes
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General election: On the campaign trail Britain's Prime Minister Boris Johnson visits a Christmas market in Salisbury
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General election: On the campaign trail Liberal Democrat Leader Jo Swinson on the election campaign bus on route to Chelmsford
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General election: On the campaign trail Labour leader Jeremy Corbyn talking to a university worker outside Birkbeck/SOAS University of London, at the announcement of his parties of the plan for the extension of workers' rights
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General election: On the campaign trail Nicola Sturgeon plays a game with string during a visit to Perth and District YMCA
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General election: On the campaign trail Brexit Party leader Nigel Farage picks up a copy of The Brexiteer during a visit to JPI Printers in Dinnington
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General election: On the campaign trail Boris Johnson, centre, talks to veteran James Gammer as he visits a veterans centre
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General election: On the campaign trail SNP supporters meet First Minister Nicola Sturgeon following her address during a St Andrews day election speech
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General election: On the campaign trail Jeremy Corbyn has a photo taken outside Birkbeck/SOAS University
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General election: On the campaign trail Liberal Democrat leader Jo Swinson during a visit to the Cardiff United Synagogue
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General election: On the campaign trail Brexit Party leader Nigel Farage reacts as he attends an election debate
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General election: On the campaign trail Jeremy Corbyn wears a jacked displaying Labour's slogan 'For the many, not the few'
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General election: On the campaign trail Prime Minister Boris Johnson on The Andrew Marr Show
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General election: On the campaign trail Nicola Sturgeon plays with local children during a visit to the Jelly Tots & Cookies Play Cafe in Uddingston, South Lanarkshire
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General election: On the campaign trail Opposition Labour Party leader Jeremy Corbyn eats some chips in Whitby, northern England
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General election: On the campaign trail Boris Johnson and Conservative MP George Eustice, left, tour 'Rodda's Clotted Cream' whilst campaigning in Cornwall
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General election: On the campaign trail Jo Swinson during a visit to Dunkertons Cider Company, an organic and plastic free brewery in Cheltenham
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General election: On the campaign trail Jeremy Corbyn holds up unreacted documents with NHS staff. Mr Corbyn released uncensored official documents which he says provides confirmation that the NHS is on the table in trade talks with the USA
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General election: On the campaign trail Nigel Farage meets locals in Barnsley market
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General election: On the campaign trail Nicola Sturgeon launches the SNP's general election manifesto
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General election: On the campaign trail Labour Party leader Jeremy Corbyn addresses the audience during the launch of Labour's environmental policy in Southampton
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General election: On the campaign trail Boris Johnson tries an apple as he visits Healey's Cornish Cyder Farm in Callestick
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General election: On the campaign trail Jo Swinson helps make a chicken tikka masala during a visit to the Ashoka restaurant in Bearsden, Glasgow
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General election: On the campaign trail Nigel Farage playing golf on a range at One Stop Golf in Hull
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General election: On the campaign trail Jeremy Corbyn addresses the audience during a climate emergency rally in Falmouth
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General election: On the campaign trail Liberal Democrat leader Jo Swinson meets supporters during a visit to Dunkertons Cider Company
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General election: On the campaign trail Boris Johnson visits Chulmleigh College
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General election: On the campaign trail Labour Party leader Jeremy Corbyn as he appearing on the BBC political programme The Andrew Neil Show. The opposition leader defended his handling of anti-Semitism allegations after Britain's most senior rabbi suggested the issue was a "new poison" within the party that had been "sanctioned from the very top". In an unprecedented intervention ahead of next month's election, Chief Rabbi Ephraim Mirvis suggested Corbyn was "unfit for high office" due to his perceived failure to clamp down on the problem within the party
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General election: On the campaign trail
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General election: On the campaign trail Prime Minister Boris Johnson launches the Conservative Party Scottish Manifesto in North Queensferry
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General election: On the campaign trail Britain's Opposition leader Jeremy Corbyn poses with WASPI (Women Against State Pension Inequality) supporters after he outlined Labour's plans to repay the "historical debt of honour" owed to women born in the 1950's
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General election: On the campaign trail Jo Swinson alongside the Lib Dem's candidate for Truro and Falmouth, Ruth Gripper, and founder of Finisterre, Tom Kay, during a tour of the British surfing brand, which creates sustainable surfing gear, in St Agnes, Cornwall
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General election: On the campaign trail Prime Minister Boris Johnson poses with sheep as he visits the Royal Welsh Showground, in Llanelwedd
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General election: On the campaign trail A coalition of NHS (National Health Service) campaigners led by "Keep Our NHS Public" and "We Own It", pose for photographs with masks of US President Donal Trump, right, and Prime Minister Boris Johnson carving up the NHS with a giant knife and fork, as they take part in a demonstration on Parliament Square. The campaigners are calling for the NHS to be taken "off the table" in a trade deal with the US by ending privatisation in the health service and restoring it to a wholly publicly owned and provided service
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General election: On the campaign trail Brexit Party leader Nigel Farage visits Plymouth Fisheries at Sutton Harbour
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General election: On the campaign trail SNP leader Nicola Sturgeon gives her party's candidate for North East Fife Stephen Gethins a haircut, during a visit to Craig Boyd Hairdressing in Leven
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General election: On the campaign trail Vans belonging to The Community United against Labour Party anti-Semitism group, Culpa, parked next to a police car ahead of the Labour Race and Faith Manifesto launch
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General election: On the campaign trail Boris Johnson prepares to serve food at the Royal Welsh Showground
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General election: On the campaign trail Jeremy Corbyn tries his hand at bricklaying during a visit to the West Nottinghamshire College Construction Centre, in Ashfield
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General election: On the campaign trail Liberal Democrat leader Jo Swinson during a visit to the London design museum to discuss the party's tech policy
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General election: On the campaign trail Brexit Party leader Nigel Farage visits Seaham
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General election: On the campaign trail Britain's Prime Minister Boris Johnson arrives for the Conservative party's manifesto launch in Telford
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General election: On the campaign trail Labour Party leader Jeremy Corbyn meets supporters during a visit to Thurrock in Essex
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General election: On the campaign trail Protesters wait for the arrival of Prime Minister Boris Johnson ahead of the launch of his party's manifesto
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General election: On the campaign trail Jo Swinson gestures from atop a crane during a visit to an eco home building site in Sheffield
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General election: On the campaign trail Jeremy Corbyn meets a supporter on a train on his return from a visit to Sheffield
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General election: On the campaign trail Prime Minister Boris Johnson during a visit to Bassetlaw District General Hospital in Worksop, Nottinghamshire
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General election: On the campaign trail Nigel Farage campaigns in Hartlepool
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General election: On the campaign trail Jeremy Corbyn outside an Amazon depot in Sheffield, to announce plans for a workers' rights revolution and to ensure big businesses pay their fair share of taxes
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General election: On the campaign trail Prime Minister Boris Johnson, Liberal Democrat leader Jo Swinson, First Minister of Scotland Nicola Sturgeon and Labour leader Jeremy Corbyn, during their successive appearances on BBC Question Time Leaders' Special at the Octagon in Sheffield
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General election: On the campaign trail Liberal Democratic Party leader Jo Swinson visits a primary school in Cambridge
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General election: On the campaign trail Boris Johnson lays a brick during a visit to the Barratt Homes
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General election: On the campaign trail Labour leader Jeremy Corbyn attends the launch of the party's election manifesto at Birmingham City University
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General election: On the campaign trail Brexit Party leader Nigel Farage holds his party policy document during the party's policy launch in Westminster
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General election: On the campaign trail SNP leader Nicola Sturgeon joined Dundee East candidate Stewart Hosie to made a keynote speech at The Quay
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General election: On the campaign trail Prime Minister Boris Johnson holds a part of an electrical appliance during a General Election campaign trail stop at Ebac in Newton Aycliffe
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General election: On the campaign trail Jeremy Corbyn poses during a visit to The Oatcake Boat on the Trent & Mersey Canal, Stoke
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General election: On the campaign trail Jo Swinson and Willie Rennie Leader of the Scottish Liberal Democrats gesture, during a visit to Glasgow
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General election: On the campaign trail
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General election: On the campaign trail Liberal Democrat leader Jo Swinson (left) during a visit to the Gurdwara Singh Sabha Temple in Glasgow
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General election: On the campaign trail Labour leader Jeremy Corbyn meets Colin and his mother after a speech at the University of Lancaster
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General election: On the campaign trail Britain's Green Party co-leaders Jonathan Bartley, Sian Berry, and deputy leader Amelia Womack, wave during the launch of the party manifesto at the Observatory at London Wetland Centre
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General election: On the campaign trail Scottish Nationalist Party leader Nicola Sturgeon meets voters and activists at Cafe Roma in Clarkston, Glasgow
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General election: On the campaign trail Protestors participate in an anti-Boris Johnson rally in his constituency Uxbridge, west London
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General election: On the campaign trail Brexit Party leader Nigel Farage looks out from a window on the Kestrel crabbing boat in Grimsby fish dock
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General election: On the campaign trail Prime Minister Boris Johnson on a tug boat in the port of Bristol
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General election: On the campaign trail Green Party Co-Leader Sian Berry has a selfie taken with a supporter at the Observatory, London Wetlands Centre
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General election: On the campaign trail Jo Swinson helps chef Leonardo Mastofilippo to make pizza during a campaign visit to cafe Amisha in South Bermonsey
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General election: On the campaign trail Labour leader Jeremy Corbyn with WASPI (Women Against State Pension Inequality) ladies during a visit to Birkenshaw Sports Barn in Uddingston
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General election: On the campaign trail Boris Johnson at the unveiling of the Conservative Party battlebus in Middleton, Greater Manchester
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General election: On the campaign trail Nicola Sturgeon sits alongside Cycling Without Age user Cyril Corcoran (centre), aged 78, in an electric tricycle during a visit to Hawick, in the Scottish Borders
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General election: On the campaign trail Nigel Farage holds a fish during a stop at the Grimsby Seafood Village
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General election: On the campaign trail Liberal Democrats leader Jo Swinson in the boxing ring at Total Boxer, a specialised boxing gym which offers training to young people as a means of keeping them away from violence, in Crouch End, London
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General election: On the campaign trail Britain's Prime Minister Boris Johnson reacts as he participates in a school art lesson, making a clay figure at George Spencer Academy, west of Nottingham
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General election: On the campaign trail Labour Party leader Jeremy Corbyn during a visit to the Heart of Scotstoun Community Centre in Glasgow
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General election: On the campaign trail Scotland's First Minister and SNP leader Nicola Sturgeon visits the Cafe Gelato in Rutherglen, Glasgow
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General election: On the campaign trail The Green Party launch in Bristol
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General election: On the campaign trail Farage enjoys some chips at the start of a nationwide tour for the 2019 general election, in Whitehaven
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General election: On the campaign trail Labour leader Jeremy Corbyn unveils the Labour battle bus in Liverpool
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General election: On the campaign trail Boris Johnson reacts as he talks with workers whilst weighing packaged tea bags at the Tetley Tea Factory in Stockton-on-Tees
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General election: On the campaign trail Brexit Party leader Nigel Farage on the campaign trail in Whitehaven, where he was confronted by Karl Connor
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General election: On the campaign trail Lib Dem leader Jo Swinson speaks to volunteer Rosie Squires in the Stainforth 4 All charity shop during a visit to Stainforth in South Yorkshire to meet people affected by flooding
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General election: On the campaign trail Nicola Sturgeon poses with candidates during the SNP general election campaign launch in Edinburgh
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General election: On the campaign trail Labour Party leader Jeremy Corbyn with Laura McAlpine, the party's candidate for Harlow
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General election: On the campaign trail Anti-Boris Johnson protesters demonstrate outside the hall where the Conservative Party were launching their campaign in Birmingham
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General election: On the campaign trail Green Party Co-Leader Sian Berry (left), Deputy Leader and Parliamentary Candidate for Newport West Amelia Womack (right), and Bristol West Candidate Carla Denyer (centre) at the launch of the party's general election manifesto in Bristol
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General election: On the campaign trail The PM tastes whisky during a visit to Diageo's Roseisle Distillery near Elgin, Scotland
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General election: On the campaign trail Nigel Farage poses with boxer Dereck Chisora during a visit to a boxing gym in Ilford
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General election: On the campaign trail Jo Swinson visits a science class at Hinchley Wood School near Esher
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General election: On the campaign trail First Minister Nicola Sturgeon holds a guitar as she visits Dalkeith Community Hub
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General election: On the campaign trail A man heckles as Jeremy Corbyn gives a speech at the Senior Citizens Hall in Macclesfield
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General election: On the campaign trail Britain's opposition Labour Party leader Jeremy Corbyn visits residents affected by flooding in Conisbrough
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General election: On the campaign trail Boris Johnson gestures as he helps quality control staff during a visit to the Tayto Castle crisp factory in County Armagh, Northern Ireland
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General election: On the campaign trail The Lib Dem leader eats a marshmallow during a visit to Free Rangers Nursery in Midsomer Norton, Somerset
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General election: On the campaign trail Nigel Farage visits a butcher's shop in Sutton-in-Ashfield
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General election: On the campaign trail SNP leader Nicola Sturgeon visits Blosson Tree children's nursery
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General election: On the campaign trail Jeremy Corbyn laughs during a visit to the Scrap Creative Reuse Arts Project, Sunny Bank Mills
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General election: On the campaign trail Prime Minister Boris Johnson hold Rosie the rabbit during a visit to a primary school while on the campaign trail in Taunton
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General election: On the campaign trail Jo Swinson playing with children at the Battersea Arts Centre in Lavender Hill
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General election: On the campaign trail Farage addresses supporters at the Washington Central Hotel in Workington
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General election: On the campaign trail Jeremy Corbyn poses with Labour activists as they canvas in Govan, Glasgow
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General election: On the campaign trail Nicola Sturgeon during a visit to The Shed, a Climate Challenge community project at North Edinburgh Arts
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General election: On the campaign trail Prime Minister Boris Johnson meets six month old Willow Rose Anderson, at the Lych Gate Tavern in Wolverhampton
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General election: On the campaign trail Jo Swinson holds up a sack of barley during a visit to Crafty Maltsters Scotland
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General election: On the campaign trail Jeremy Corbyn tries a scone in Bentley, Doncaster
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General election: On the campaign trail Nigel Farage takes a mouthful of homemade cheesecake during a stop at the Grimsby Seafood Village
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General election: On the campaign trail Boris Johnson hauling a consignment of frozen chocolate gateaux, during a visit to Iceland Foods HQ in Deeside
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General election: On the campaign trail Jo Swinson puts on a high visibility jacket during a visit to Sigma Pharmaceuticals, a family run pharmaceutical wholesaler in Watford
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He said: “This means we are reaching a crunch point. As a patient sitting on a ward you will see doctors less often than you did 10 years ago.
“They will be looking after more patients and being expected to turn them around in hospital much more quickly, but we are at a stage where we can’t do that anymore.”
He added: “With the increase in admissions and the reduction in beds over the past 20 years, the only reason we have managed to keep everything working is because we have reduced lengths of stay. But because the population is getting older and is more frail, that is getting harder and harder.
“Because of social care and the inability to discharge people, we are reaching stagnation.”
Asked why he was intervening during the election, Prof Goddard said: “We are a royal college and very aware of our charitable status, however, our members and fellows look to us to provide leadership when it comes to talking about the NHS.
“I would be failing as the leader of the college if we didn’t represent our viewpoint.”
He said he was frustrated “by the proposed policies and promises that are being made by both sides and their relationship to reality and what actually is deliverable”.
Labour Party proposals to train 5,000 more GPs would mean fewer doctors training in psychiatry, or emergency medicine, he warned. Equally, the Tories’ plan to have 6,000 more GPs by 2024 was not feasible without “flooding” the trainee system with overseas doctors; he also warned an increasing number of doctors were not prepared to work full time.
He said the NHS was not “up for sale” as Labour had claimed, but also expressed concern over the effect of trade deals on drug prices emphasising the Treasury should formally mitigate any increase if a trade deal delivered a net increase in money for the country but a cost to the NHS.
He said both main parties had used the NHS as a football in recent weeks adding: “It’s really hard. In my life I have voted for all three main political parties. I currently have internal conflicts on which way I will vote, there is no easy choice.
“None of the parties has thought about the long-term problems facing us.
“The promises that have been made in the manifestos are not physically possible because we don’t have enough people training to fulfil those promises. We need to think about where we want to be in 15 years’ time and plan for it now.”
Currently the NHS pays around £1.5bn to train around 7,250 doctors a year, but Prof Goddard said this should rise to 15,000 a year, a cost in excess of £3bn.
Prof Goddard, who ran the RCP’s workforce unit for five years, said the increase was doable, but added: “Do we really need a five-year course? Can we do it in four? I think we need to look at the model. The infrastructure is there.”
He added: “These are things within our grasp to understand and do something about it. The solution going forward has to be a long-term one, it can’t be done on a political cycle because that is too short term.”
He said care of NHS patients “remained of a remarkable standard” but for it to be maintained action was needed.
Support free-thinking journalism and attend Independent events Prof Goddard's comments came as new analysis of official figures showed cancer patients were enduring the worst waiting times since records began.
Between April and September, for all nine national NHS cancer targets the lowest proportion of patients were treated on time since the standards were introduced a decade ago.
Targets were missed a total of 168,390 times in that period, according to Nuffield Trust and Health Foundation analysis published by The Sunday Times .
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