There are two main problems with the ‘Choose Your GP practice’ idea, proposed by all 3 main political parties, and welcomed by many well-meaning patients and patient groups who are frustrated in many ways by the current state of affairs. The first obstacle is that of capacity: most practices are currently working at full capacity. There simply is not significant spare capacity at that wonderful practice you have heard about 15 miles away. The second problem (and this covers a myriad of issues) is that looking after patients at a distance from the practice does not work: it is ok for people who are well, organised, and mobile, but not for people who are sick. This is how it is. Policy makers have to accept and work with these facts of nature.
In the press release on 30 December 2011 (why choose such a date?), we read:
“Busy commuters will benefit the most from the new pilot scheme, which allows patients for the first time to choose whether to register with a practice close to their workplace or home, without worrying about practice boundaries.
The announcement means commuters in the pilot areas, who are often away from their local area during the working day, will find it easier to see their doctor where it suits them, and receive the same services as in their old practice.
The pilot, which will begin in April 2012 and last for one year, will also come as a relief to people who are moving home and wish to remain with their preferred practice, and families who would like a practice near to their children’s school.”
The press reported this, just reproducing, without any questioning or any irony, what the DOH press office gave them.
Where are we now? The launch had to be delayed by a month while the DOH ironed out some practicalities, and then the East London LMCs wrote to GPs advising them to boycott the pilot unless it was properly funded, then the recent LMC conference (if I am not mistaken) voted to reject the pilot. And then we have a robust report (see link below) commissioned by the Corporation of London and NHS London North East and the City analysing the primary care needs of the City of London with its resident population of 11,700 and one GP practice within its area, and approximately 360,000 working population who might want to avail themselves of Andrew Lansley’s offer. It is obvious that the current primary care infrastructure in the City of London is in no position to provide what Lansley and the DOH have offered. What were they thinking?
There was a Czech documentary in 2004 (Czech Dream) which perpetrated a hoax on the Czech public, with advertising for a hypermarket due to open shortly. But there was no hypermarket, just a life-size poster of a hypermarket held up by scaffolding. A crowd of several thousand gathered in a field for the ‘opening’, attracted by the promised sales, and ran across the field after the ribbon was cut.
In some ways, a similar dynamic is at work here. But I am not sure if Lansley or the DOH themselves are aware of the con. It is not reported in the press.
30/1/15: The policy was in fact launched on 5/1/15, very quietly. It is a mess. Czech Dream, English Dream.