My next email to Jeremy Hunt on the #gpboundaryscam

Dear Jeremy Hunt,

I have received a reply from the Department of Health following my email to you on 14/6/15.

To remind you, my email raised the concern that there was no cover in place in London (and other parts of England) for patients taking up the offer to register with GP practices at a distance from where they live. Should they fall sick at home, there is no local primary care cover for them. They have to go to a local walk in centre or to their nearest accident and emergency department. This is for the in hours part of the week. Out of hours, they are covered by whatever service is available where they live.

This policy as a whole is fraught with problems, and I have written to you and others about these. The particular problem of lack of local GP cover for these patients is one I had not anticipated.

The reply from the Department of Health contains an untruth, an error of fact: “All NHS England regional teams have arrangements in place to ensure that those patients are able to access services should they require primary medical care whilst at home.

Those arrangements vary across the country.  Many regions commission the national enhanced service model, while some use the local out-of-hours services, and others commission a range of services.  However, all have ensured that, should the patients registered in their area require care, they are able to provide it.”

This is, to put it into plain English, crap, 100% crap. In London (and other parts of the country) there are NO arrangements in place to “ensure that those patients are able to access services should they require primary care whilst at home.” There are services in place to cover patients registered locally, but not those not registered locally, which is the case of those registered at a practice at a distance from their home.

The Department of Health official points out that 14,000 people in England have registered with out of area practices and that there have been no complaints. This represents 0.026% of the population which is very small numbers. The problems will arise for patients when they are unwell.

I have tried to complain to the Parliamentary Health Ombudsman; I have been told that it is not legal for them to look into this sort of problem and they have advised I contact NHS England. This I have done several months ago, and they have still not replied. The Ombudsman advised I contact the CQC; various people I have spoken to at the CQC have felt out of their depth and do not want to handle it.

So we have a strange situation: there is a Government policy riddled with problems and in some circumstances unsafe but the system is structured in such a way that someone like myself from the frontline who raises quite basic, objective concerns is fobbed off in a Kafkaesque way. And then you wonder why GPs are emigrating.


Best wishes,


The Tredegar Practice
35 St Stephens Road
E3 5JD

“For a successful technology, reality must take precedence over public relations, for nature cannot be fooled.”  Richard Feynman, Physicist

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