My email to MPs, surname beginning with E

Dear Angela, Bill, Charlie, Christopher, Clive, David, George, Graham, Jane, Jonathan Edwards, Jonathan Evans, Julie, Louise, Maria, Michael, Natascha, Nigel, and Tobias,

I am a GP in Tower Hamlets and I am writing to MPs, one letter at a time. Each email differs, though the basic content and concern remains the same. As you might expect I am writing about the Health and Social Care Bill. There are lots of problems and controversies with the Bill; my particular concern is the proposal to eliminate practice boundaries, and allow people to register with the GP of there choice, ‘anywhere in England’. Most people think this is a good idea; I am told that all 3 major parties support this idea. From my point of view as a GP it is a mad idea; when I first heard of it about 2 years ago I thought it was a parody. You need to understand how general practice ‘works’, its ‘ecology’, to realise how unworkable this proposal is. If this proposal is implemented, proportional to the degree to which patients attempt to choose to register with a GP at a distance from their home (and proportional to the distance from their home), the complexity of general practice will increase, quality of general practice care will decrease, and in some cases safety will be compromised. See my blog for more information.

A year ago, I tried to engage Andrew Lansley in a discussion about this; he was not listening at the time: see my email exchange with him:

A few days ago, Andrew Lansley received an overwhelming vote of no confidence from the RCN’s Congress. He purported that this was because they did not understand the proposed reforms. The pause in the progress of the Bill is to attempt to communicate it more clearly. Do you feel, as a politician, embarrassed by this?

One reason the nurses may have been incensed was due to David Cameron’s address to the same group a year ago, before the General Election:

I am writing as a simple citizen who happens to work as a GP trying to deliver good quality general practice. My wish list is this: that if politicians are involved in planning the healthcare system, that their contribution leads to improvements; that they base their decisions on evidence; that they work collaboratively with people who actually know about the systems and services involved; that they remain independent of financially powerful lobby groups; that they ‘model’ the ideas they wish to implement, and weigh up the true benefits and risks. At present, my feeling is that we are a long way from this.

See Ben Goldacre’s article, just published, analysing the Department of Health’s booklet Working Together for a Strong NHS:

Can you understand why, faced with dishonest spin, we are demoralised and bewildered?

One last link: to a lecture introducing a book called The Plot Against the NHS. I have read the article and am reading the book. I must say it helps make sense of why these otherwise implausible policies are foisted on us.

My plea to you is that you inform yourselves and vote with your conscience and not necessarily with your Whip.

Best wishes,


The Tredegar Practice 35 St Stephens Road London E3 5JD!/onegpprotest

[Same email, with some additions, sent to MPs surnames starting with F, copied to Health Ministers and Health Select Committee]

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