[Cut to the chase: for those wanting an overview of the GP practice boundary issue, see my Submission to the Health Select Committee.
For my emails to Jeremy Hunt and the 'non-replies' from the Department of Health, click here.]
I am a GP in Tower Hamlets. My name is George Farrelly. My wife and I have been the GPs in a small practice called the Tredegar Practice for 23 years. We have two part time GP colleagues working with us. We are very grateful for their contribution.
This blog aims to protest and to inform. My main point is this: the politicians and planners are making promises to you which are unrealistic and unworkable; & they are making demands of us which we cannot meet without going crazy. I am protesting against some policies. Not all of them are mad, but some are. The problem is that the whole system gets subverted by these few policies. I am protesting mainly about two policies; no doubt there are other mad policies, but I leave it to others to highlight these.
Mad policy No. 1: In 2010, in the run up to the general election, the three main political parties all declared that they were in favour of abolishing GP practice boundaries, allowing patients to register with the practice of their choice, anywhere. This sounds like a good idea, and most people would welcome such a scheme. But as someone who has worked as a GP attempting to provide good quality general practice for 25 years I can tell you that it is quite mad. Click here for further information.
Mad policy No. 2: The 2004 GP contract introduced a number of changes. One was to pay practices for providing evidence-based pro-active care for a number of conditions. On the whole we welcomed this as we were already trying to provide this, but were not given extra resource for doing so. I thought we could look after a smaller number of patients well, and maintain our income (we had to pay our mortgage and utility bills). But they also stipulated that we could not limit the number of patients who wanted to join us: we had to take all comers. This meant that we found ourselves looking after more patients than we could cope with, so the quality of our service (access, time spent with individual patients, ability to cope with workload safely, staff morale) declined.
The Department of Health do not seem to understand the issue of capacity. It is not on their radar; the area of the organisational brain that might deal with this is shut down. They think the overriding issue is CHOICE. Choice trumps everything else. If you want to look at this issue, then click here.