I am writing to all MPs, one letter at a time. Each letter is different. You are the H’s.
Quick summary: the proposal to abolish GP practice boundaries and give people more choice sounds good at first sight; but the practicalities mean that patients living at a distance from the practice receive poorer care; it is more resource consuming for the practice; and in some cases it is unsafe. Read on if interested; if not, press delete.
All three major political parties share the idea that abolishing GP practice boundaries is desirable. At some point in the future this will be exposed as a very stupid idea, especially when they try to implement it. Do you want to know why?
My wife and I have worked in a small practice in Tower Hamlets for 20 years. When we were interviewed to take this practice over when it became vacant in 1991, we were asked what we were going to do about the ‘outliers’ (people living outside the practice area). At that time, it was thought to be bad practice to have patients living at a distance from the surgery, and good practice to serve a community living close to the surgery. We have a relatively high turnover of patients and people move out of the area; and because we are popular, many of our patients try to continue using us as their GPs even after they have moved away. So we have had a lot of experience of trying to look after patients who live at a distance from the practice: we have acted in a way as a pilot site for this proposal.
And we can say that it is quite disastrous: patients don’t consult us appropriately: they leave things too late, or they don’t consult at all (and important things are neglected); or they save things up so they only make one trip and they then over-run their 10 minute appointment considerably; and then there is the problem of local services (which they are unable to engage with), and on and on. So to us this proposal is really quite mad.
In addition, it is unworkable because GPs are currently at full capacity; how are the popular GPs going to register more patients? And if they do, what about the local residents? For example, if 10% of the commuter population of 100,000 working inCanaryWharfdecide they want to register with a local GP, this will disrupt services for the current local population of 30,000 who are served by 4 GP practices. They simply do not have the capacity to grow by 30%. And so on.
‘Choice’ has consequences, some intended, some not intended. There is no evidence that Andrew Lansley has thought this through; there is evidence that he has not thought this through: see my attempted email exchange with him from March 2010 http://bit.ly/f4iTA1
See the Royal College of GPs’ response to the New Labour’s so-called consultation on this issue http://bit.ly/l3FrUA
For a brief overview of the problem http://bit.ly/lo3hWq
I am aware that there is a convention that MPs only deal with issues raised by their own constituents, and their expenses.
I am not writing to you as a constituent, but as a lobbyist. I am not paid by an American private healthcare multinational; I am lobbying as a citizen who happens to be a GP. Why am I doing this, at my expense in terms of time and petty costs? Because I valueUKprimary care and I do not wish to see you politicians flush it down the toilet bowl.
To the politicians of integrity, I wish you well.