A member of the public has posted this comment on my Home Page:
Dear Dr Farrelly,
I will admit you have changed my mind on the subject of the need to register locally. I specifically think the examples you give bring home the reality of boundary changes in many situations.
If the boundary registration was removed, does the new system say you must accept all who try to register with you? Or can you refuse applicants on the basis of there distance from your surgery? I would guess that you must be able to say no to some patients in the new system otherwise you could end up with all of London registered with one GP service that has a “good” reputation (hypothetically)
Also if the new system was introduced and GPs had the option of refusing certain patients would this lead to private providers “cherry picking” patients. For example only registering young working professions leaving you with the more complicated and expensive patients such as haemophiliacs etc.
I ask as I travel within the UK I was originally drawn to the idea of open boundaries and the virgin assura system of connected health centres across the UK but I am now concerned that such an action may be of mild benefit to me but lead to a great dis-benefit for the majority of patients.
Anyway thank you for a informative website
Thank you for your thoughtful and generous comment. Will we be forced to accept all comers if boundaries are abolished? Clearly, this would be a recipe for disaster. And yet, if people are not able to register with the GP practice of their choice, ‘anywhere in England’, they will rightly feel aggrieved, having been promised this. The practicalities have not appeared in public; I imagine there are a number of middle-ranking people at the DoH sweating to somehow square the circle. Cherry picking: yes, this will appear in different ways. You are, I think, right that people like you will benefit but many others will not, and English (not Scottish or Welsh for the moment) general practice will suffer.
Watch this space. The anomalies and absurdities will emerge in time. This is a scandal in search of an audience.