My email to Peer, via 38 Degrees

06/10/2011

 

Dear Baroness Stedman-Scott,

 

I am a GP in Tower Hamlets. I have grave concerns about the Government’s Health & Social Care Bill. You will be aware of the concerns about various ingredients of this bill. I have quite a lot of experience relating to one of the Bill’s proposals: to abolish GP practice boundaries. I have resorted to writing a blog about this issue, and emailing MPs in the House of Commons. This proposal sounds like a good idea, and all 3 major parties support this policy. However, to most GPs it seems madness: this because of the nature of general practice and how it works. This proposal is simply unworkable: it will increase inefficiencies and at times be dangerous, it will cost more, and it will not deliver what it claims to be aiming for, patient choice. How intelligent people can actually champion such an idea is beyond me; but of course there is probably an underlying, unstated/hidden agenda. For a summary of the problem, with links to back my allegations, see

http://bit.ly/pMWLNb

If the Secretary of State for Health can get it so wrong for this particular issue, I have little faith in his competence and methodology to deliver a credible solution to the many challenges facing us all in the NHS. I hope the House of Lords scrutinise this Bill with care and resist proposals which lack an evidence base and will undermine the NHS.

 

Yours sincerely,

 

George Farrelly

Write to a Peer:      http://bit.ly/qLhQhM

 


An early morning email to Lib Dem MPs

15/09/2011

It’s me again, I’m afraid. I thought I better warn you about what almost certainly lies ahead with respect to the issue of GP practice boundaries.

I have never felt that this added up: from a practical point of view, it just does not make sense at all. I thought these politicians and DoH planners were just grotesquely stupid.

The reality is almost certainly one of deceipt and corruption, with the rest of politicians either complicit or just naïve.

A member of the public left a comment on my blog yesterday; he had joined up the dots, and at the end he mentioned the ‘virgin assura system of connected health centres across the UK’. I was unaware that such a thing existed. I had hypothesised that such a thing would exist in the future and that this was why they wanted to abolish GP proactice boundaries. But I woke this morning at 4am and thought I would just check, and, lo and behold, I found this.

I suggest you have a look at the leaflet that the DoH and New Labour produced  to accompany the so-called ‘Consultation’ on the question of GP boundaries in March 2010. Notice that nowhere in the leaflet, and nowhere in the larger consultation documentation, do they say: ‘and you could join the Virgin Assura system of connected health centres’, but this is in effect what the abolishing of GP practice boundaries will do. That is why they want to do it, otherwise it just does not make sense. All this talk of ‘patient choice’ is just camouflage. Just have a look at Virgin’s website, and then look at the DoH leaflet. The leaflet is a promotion of what Virgin is offering. And note that the proponents of this policy use the results of the ‘Consultation’ as evidence that the English public want this. But the ‘Consultation’ was pitched in such a way so as to produce this result, the questions are skewed in this direction.

There is really a lot more to this, and it will come out in the open in due course, I am sure. Because the media (who up to now have been crap about this issue, completely uninterested) is going to wake up soon and start shining a light on this.

Why am I writing to you at 4am? Because you people are heading off to your conference and you have been told by your leader that you cannot mention the NHS. And yet, shouldn’t you be talking about this?? Nick Clegg may have some sort of future as a Tory MP, but the Lib Dem party will have had it entirely when it becomes clear that you have been duped and used, along with the English public, as the NHS is swallowed up the the piranhas. Once they pass the law, there will be no going back.

I just thought I had better warn you.

And now I’ll have some breakfast, and then go to the surgery and see some patients, all of whom live local to the practice.

Best wishes,

George


Does the average MP understand how general practice works?

11/09/2011

On a previous post I included an email exchange with an MP. The MP had responded to one of my emails to MPs, on the topic of GP practice boundaries. The MP said: “I must say that I do have some sympathy with the idea of free registration.  I had an excellent GP in XX who I was with from the age of 19 when I went to University.  It seems strange that I could not remain with that GP when I only live 40mins away in YY.”

Now most GPs will think it is obvious why living 40 minutes driving distance (according to the AA route finder it is about 34 miles) is not practical. What is worrying is that this well-meaning MP, who is voting on the Health Bill which includes the GP boundary issue, is not aware why 40 minutes/34 miles is problematic.

What is the average MP’s understanding of the structure and ecology of general practice?


Email exchange with MP on GP practice boundaries

11/09/2011

I received the following email a few months ago, in response to one of my emails to MPs. I have been emailing one alphabetical letter at a time.

Dear Dr Farrelly,

Thank you for emailing me.  I congratulate you on your efforts to contact all MPs and taking the trouble to make sure that you semi-personalise the email.

I will read the attachments you have sent.

I must say that I do have some sympathy with the idea of free registration.  I had an excellent GP in Exeter* who I was with from the age of 19 when I went to University.  It seems strange that I could not remain with that GP when I only live 40mins away in Lyme Regis.

I would be interested in your thoughts on this.

Best wishes,

X

* [This MP did not go to university in Exeter, nor lives in Lyme Regis, and is not the MP for that area of the country; I have changed the names but the geographical distance comparable. This MP wrote in a good-natured way and was not expecting me to make this public and discuss its contents in public, and I am maintaining her/his anonymity. But I am making the contents public because I think it illustrates some important issues. I reproduce below my response.]

*

Dear X,

Thank you for responding to my email some months ago. I replied briefly at the time, and am now sending a more complete reply. I am making this public on my blog, without divulging your identity.

In your email you say that you would have liked to remain registered with the excellent GP in Exeter and that ‘it seems strange that I could not remain with that GP when I only live 40mins away’. I too have patients who move away and would like to remain registered with me. What I say to them is this: for me to offer you good care it is essential that you can get to me easily, and that I can get to you easily. With you living 40 minutes away by car, it makes this impractical. I know that it is difficult for you and that you have built up a relationship with us, but in the interests of safety and good practice I have to insist that you get a local GP near where you live.

Patients usually then acknowledge there are real practical issues, and get registered locally.

But I will illustrate this further with an example. Let us say you develop pyelonephritis; this is a kidney infection which needs urgent assessment (physical examination, urine sample) and treatment with high dose antibiotics, and often  admission to hospital. You would feel pretty ill, and might well be too ill to travel to Exeter, and I would certainly not be able to take 40 minutes to drive to Lyme Regis to assess you (80 minutes round trip, with perhaps 15-20 minutes to assess you). Now it is possible to treat pyelonephritis at home but it needs close monitoring and admission if you get worse (for a variety of reasons we would prefer to manage you at home, but this is not without risk). This is not something that can be managed over the telephone. We might well want to see you again the following day. You will understand all this cannot happen at a 40 minute’s drive distance. It simply does not work.

This is an example of an acute, serious illness (this can happen to anyone, no matter how healthy). But there are a variety of other conditions which might require regular visits to the surgery, such as hypertension: initial screening to identify the problem (are you likely to answer an invitation to have a vascular risk assessment if you have to drive 80 minutes for this, and you feel perfectly well? If you lived nearby you could drop in on your way home from work, or fit it in on a day off when you are doing some gardening); repeated visits to get your blood pressure under control; once
stable, 2 visits a year for assessment.

And if you have need of a district nurse, the team attached to your GP surgery in Exeter will not be able to visit you (at least not without a drain on their [limited]resources in terms of time). And who is going to pay for you? The PCT covering Exeter is likely to not cover Lyme Regis. So if you have a hernia repair, will this come out of Exeter’s budget (which will have been worked out for that area’s population), in which case this will be taking a (limited) resource away from the Exeter health economy; or do you set up a layer of bureaucracy so that ‘money follows the patient’? And to have your stitches removed 1 week after your hernia repair, do you drive 80 minutes for this?

One other possibly hidden systemic impact of this: all practices have a capacity limit. They can look after a given number of patients well, and if the numbers exceed this at some point quality will decline. So your Exeter GP surgery will not have unlimited capacity. If you, 40 minutes away and fit and healthy, are registered at his practice, it is possible that a person living in the GP’s practice area will not be able to register. That is, you are taking up a place that otherwise would have been occupied by a local.
(This is the way it is with our practice in Tower Hamlets: we keep the list size at 3,520 give or take; as people leave the area and the list, other local people register; if we had non-local people on our list this would be at the expense of local residents; so in our case, it does not make any sense whatsoever to register people who live at a distance from the practice and we cannot look after properly, when local demand exceeds supply).

My wife is a member of  the recently created Tower Hamlets Clinical Commissioning Group. She points out that the proposal to abolish practice boundaries conflicts with the proposal the create Health and Wellbeing Boards which are geographically based and are meant to feed into commissioning for the needs of the local population. But if we have a significant number of non-Tower Hamlets residents registered with us (commuters to Canary Wharf number ~100,000, local resident population ~30,000), where do they fit in? They will be using local resources for non-local people. And if our residents register in other jurisdictions, how are their needs assessed and commissioned for?

I could go on, and on. But I think you get the picture. Good quality general practice is a very complex technology. As a system it is local; the system works as integrated local network. To ask it to perform the same service for an expanded territory is foolhardy. It simply does not work.

In the coming months it is likely that there will be a battle between the government and the the GPC on this; then there will be anger by GPs over this. And the reason GPs will be angry is because we are being asked (forced) to do something which is unworkable, and will impact negatively on our work.

Anyway, I must stop there. Again, many thanks for taking the time to respond to my original email and in taking an interest.

I wish you all the best with your work as an MP, and life in general,

George

*

For my email exchange with ‘Andrew Lansley’, click here


My question to Lib/Dem MPs on GP practice boundaries

08/09/2011

Dear Liberal Democrat MPs,

As you will be aware, one of the policies in the Health Bill is the proposal to abolish GP practice boundaries. You may be less aware that most GPs think this is a very bad idea, and that the GPC will be resisting this ‘staunchly’ in their negotiations with the Government and Department of Health. It is said this this is to be a ‘battleground’ in the coming months.

I am a GP in Tower Hamlets. I have written to you as a group before.

I am writing now to put to you the same question I put to Andrew Lansley in March 2010: do you have a position paper, feasibility study, or related documentation which gives evidence that you have considered not only the benefits but also the risks of this idea [abolishing GP boundaries], and that you understand the nature of general practice (and here I mean quality general practice)?

I don’t know who within the Lib/Dem party is best able to answer this question so I am writing to you all.

Best wishes,

George

The Tredegar Practice 35  St Stephens Road London E3 5JD

www.onegpprotest.org

http://twitter.com/#!/onegpprotest

Plot Against the NHS? Read this: http://bit.ly/ePWSQ8


My email to MPs, surnames beginning I & J

26/06/2011

 

Dear Alan, Andrew, Bernard, Cathy, Dan, David, Diana, Eric, Gareth, Glenda, Graham, Helen, Huw, Jo, Kevan, Marcus, Margot, Sajid,Sian, Stewart, Susan, and Tessa,

Summary: All 3 major political parties are in favour of dropping GP practice boundaries and allowing people in England to register with GP practice of their choice, anywhere in England. Sounds like a good idea; but if you understand how general practice works and think through the issue, it is filled with problems: to look after a patient who lives at a distance from the practice leads to poorer care for the patient, increased use of resources by the practice, and it is sometimes unsafe. There are other risks as well; & it will cost more. The Government is pressing ahead with this. The recent LMC GP conference voted overwhelmingly to resist this policy. So this could become a battleground in the coming months. How might this play out? If a light is shone on this issue, who will come out looking stupid? Or is there an unstated aim with this, part of what some have called ‘the plot against the NHS’?

If this does not interest you, click delete.

*

I am a GP in Tower Hamlets. When my wife and I were interviewed in 1991 to take over a GP practice that had become vacant, we were asked what we were going to the about the ‘outliers’, those who lived outside the practice boundaries. It was then considered bad practice to have patients living at a distance from the practice, and good practice to have patients living near the practice so as to have easy access to primary care services, and to be able to link in to local integrated services when needed. Over the years we have had a lot of experience with this, and it is very clear that the quality of health care provided to a patient begins to unravel if they move away and continue to use us as their GPs (concrete examples offered through links, see below). We have to gently but firmly ask them to get a local GP. In essence, we have, de facto, carried out a 20 year pilot study on the pros and cons of practice boundaries.

So you can understand that when politicians began saying that they wanted to do away with practice boundaries a few years ago, we were bewildered. At first, I thought it was a parody. But, no, they pressed on, with Andrew Lansley taunting Alan Johnson (when he was Health Secretary) for dragging his heels over this; then Andy Burnham announcing in September 2009 that Labour intended to do away with practice boundaries within a year, and launching the so-called ‘consultation’ just before the General Election in 2010, and then Andrew Lansley of course offering it in the White Paper, and then the Health and Social Care Bill (I must say, I have tried to find where it is mentioned in the Bill and I cannot find it; in fact, the Bill is to me, as a member of the public, unreadable, impossible to understand).

From my point of view as a GP trying to provide quality general practice services to my local community, this proposal is quite mad and unworkable, and will lead to all sorts of unintended consequences which will undermine primary care services in England, cost more, and be less efficient at a time when we are being asked to cut costs and be more efficient.

So in March 2010 I emailed Andrew Lansley about this. Of course, he ignored me as he had other issues on his mind. But I pressed on, and did in the end have an email exchange with his Chief of Staff (for full text, see link below). What became evident is that Andrew Lansley and his team had not performed even a most basic feasibility study on this issue, to identify the potential risks.

At the same time, the Government (Labour) and Department of Health launched their so-called ‘consultation’ on this issue. I read the documentation with some care and was startled to find that the DoH failed to do a risk assessment. In essence, the documentation is a PR exercise gently, subtly (and not-so-subtly) nudging the reader in the direction of saying Yes to this policy. Even the questions asked in the Questionnaire were phrased in a way to elicit a ‘Yes’ vote. It was like selling a house with glossy (air brushed) photos but no structural surveyor’s report. And it reminded me of previous (New) Labour ‘dodgy’ dossiers. And the Government/DoH response to the consultation was to press on with the policy, citing the fact the majority of the 3,220 responses from members of the public were in favour of opening up choice in this way. It seems strange that 100% of members of the public were not in favour, as the way the DoH presented this policy there seemed to be no adverse costs, no adverse consequences, just increased choice. The DoH stated that they had received responses from other ‘stakeholders’, such as the BMA and RCGP (Royal College of General Practitioners) but they did not go into any detail whatsoever about whatever criticisms these responses might have contained, nor did they offer links to the documents. I offer a link to the RCGP response below.

A year ago, at a large meeting of Tower Hamlets GPs assembled to discuss Andrew Lansley’s White Paper, I asked about the issue of abolishing GP boundaries. I was told that, yes, it was a bonkers idea, but the fact that all three major political parties favour it meant that it was pointless to oppose it. At the time this did not seem to be a very good reason to go along with a stupid idea. But our local leadership had different concerns (all the issues that led to the significant opposition to the Bill, and on to the so-called ‘listening exercise’). So I decided something had to be done so I started my blog, and called it onegpprotest. I have been writing to MPs, one letter at a time. It is a slow business, loading the email addresses one at a time, composing the email (they are all different, but with substantially the same message). Some MPs have let me know that there is a convention whereby MPs only deal with issues brought to them by their own constituents, so my email to them is out of place. Well, I am not writing to you as a constituent, but as a Lobbyist. Who is funding me? Nobody. I am paying the costs of the blog, the (considerable) time of assembling and disemminating the evidence. I would prefer to be spending my time in other ways, but I think thatUKgeneral practice is a very valuable national resource, and do not want the political class to flush it down the toilet. (There are no doubt GP practices that do not offer good quality general practice, and effective ways should be found to raise standards generally; this proposed policy is not a solution to this problem). The bottom line is this: were my practice to adopt this policy the service we would provide would be poorer, and we would be able to look after fewer actual local residents (as their place would be taken by people living at a distance from the practice). So we will simply refuse to follow this policy, and make it quite clear why. And if the DoH tries to shut us down, I will fight it, but resign if needs be.

Now I was very pleased that when Clare Gerada became Chair of the RCGP she was more vocal and robust about the issue of practice areas. And pleased when I heard that at the recent LMC conference this issue was debated (nobody could be found to support it, which apparently is very unusual) and the GPC was charged with putting up a ‘staunch’ resistance to this policy in future negotiations with the DoH. The headline in Pulse reads: LMC Leaders Declare War Over Practice Boundaries.

So you can see that this issue, which currently has a very low profile and on the face of it is a rather mundane, non-sexy issue, could become an issue which will get more attention. And if light is shone on this issue, questions may begin to be asked; and when that happens whose reputations will be tarnished? Why is it that Andrew Lansley did not do a feasibility study before suggesting this policy? Why did the DoH design the ‘consultation’ in this biased way? How would Andy Burnham’s promises actually work in the real world? Why did nobody in the political class raise concerns about this issue which, after all, affects every one of their constituents?

You might say, ‘But we’re offering the English people choice…’; yes, but what is that ‘choice’? You need to ‘model’ it (in the sense of showing how it works in practice; really works in the actual world, not how you would like it to work). Most of the responses I receive to my challenges involve bringing out the ‘Choice’ word as though it is the Ace of Spades trumping all. But almost without fail, the people have not modelled it; they allude to ‘some problems which will be sorted out…’ or some similar vague gloss.

Finally, some suggest that the reason for this policy is not primarily to offer English residents choice, but to open up the system of primary care to large provider organisations on the American HMO model. In other words, by essentially de-regulating English general practice (the practice area or boundary acts as a sort of regulator), an organisation like, say, Virgin can offer primary care services which are non-geographically limited. I can register with ‘Virgin Health’ based in the city centre; most of the people who register with such a practice will be essentially healthy, mobile people with few significant chronic illnesses. Yes, it will be practical and user-friendly for these people, but as a total system of national primary care things will suffer. But of course, nobody is suggesting this, or suggesting that we debate it. And this is why some people call it a ‘plot’: it is covert. The people who subscribe to this view say that the DoH and planners dress these policies up and use the words ‘choice’, ‘modernisation’, ‘reform’ to set out a series of steps which move in a certain (unstated) direction. If this turned out to have some truth to it, then the citizens of this country might have reason to be very angry.

 

Links for further information:

The problem of Choose Your GP Practice in a Nutshell      

 My email exhange with ‘Andrew Lansley’   

Looking after patients at a distance, concrete examples:             

Patients at a distance & another example from everyday work  

My email exchange with The King’s Fund                

My email to the Patient’s Association 

RCGP Response to Choose Your GP ‘consultation’

LMC Leaders Declare War Over Practice Boundaries 

‘The Plot Against the NHS’:         This & This

Best wishes,

George

 


My email to MPs with surname beginning with G

19/05/2011

 

I am a GP in Tower Hamlets. I have a number of concerns about the Health & Social Care Bill, but have been focusing on one rather neglected one: the policy to abolish practice boundaries and allow people in England to register with the GP practice of their choice anywhere in England. All three major parties support this policy, in one form or another. At first glance, this seems like a good idea, who would not like to have greater choice? But there really are a great number of practical problems which will make it unworkable.

When my wife and I were interviewed in 1991 to take over a practice that had become vacant, we were asked what we were going to do about the ‘outliers’ on the list. At that time it was regarded as bad practice to have people living at a distance from the practice, and good practice to have a practice population which was close to the practice. In 20 years of practice, in a myriad of ways and on a daily basis, I have seen the difficulties that occur when patients move away and continue to use us as their GPs. Managing people’s healthcare when they live at a distance is more difficult for the practice, more difficult for the patient, and leads to situations that are sometimes unsafe. I am bewildered when I hear politicians and DH people say that practice boundaries are ‘outmoded’, ‘old fashioned’, ‘anachronistic’.

I tried to raise my concerns with Andrew Lansley in March 2010; for my email exchange  http://bit.ly/f4iTA1

If you want to find out why this policy is problematic, go to www.onegpprotest.org and follow the links for politicians.

I am aware that there is a convention that MPs only deal with correspondence from their constituents. I am not expecting a response. Consider me a lobbyist. An unpaid lobbyist. Why am I spending all this time writing to MPs and others? Because I think the good quality British general practice is a treasure, and this policy will undermine general practice. It may even be a sinister covert move to privatisation. For the reasoning behind this comment, http://bit.ly/jCHp2k & http://bit.ly/ePWSQ8   

I don’t harbour illusions about my efforts, but I feel we have to speak up, at least I will be able to say that I tried.

 


My email to MPs, surname beginning with E

16/04/2011

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. www.onegpprotest.org

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:

 http://bit.ly/f4iTA1

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:

http://bit.ly/fAeWqM

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.

http://bit.ly/ePWSQ8

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

Best wishes,

George

The Tredegar Practice 35 St Stephens Road London E3 5JD

www.onegpprotest.org

http://twitter.com/#!/onegpprotest

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


Email to MPs surname beginning with D….

14/04/2011

 

I am a GP in Tower Hamlets. There is a great deal of debate at the moment around the Health and Social Care Bill. I am not a member of a political party, I am a simple citizen who happens to work as a GP in a relatively deprived part ofEngland. On the whole, I am frustrated by the way politicians meddle in health and make my work more difficult, rather than helping me do my work well. Anyway, you are pausing at the moment to reflect and listen, or so you tell us.

I am writing to all MPs, one letter at a time, about an issue which is not spoken about much. I am told that all three main parties support this idea of people being able to register with the GP of their choice, anywhere in England (!). It sounds, perhaps, like a good idea, a real ‘liberation’. But you must understand the practical aspects of this idea. When I first heard of this a few years ago I thought it was a parody.

Last year the Labour government conducted a so-called ‘consultation’ on this issue. It was a PR exercise, full of distortions, misinformation, omissions. Have your read the Royal College of General Practitioner’s Response to this? If not, here is the link:

 http://www.rcgp.org.uk/pdf/RCGP_response_DH%20-%20Your%20Choice%20of%20GP%20Practice.pdf

 I tried to question Andrew Lansley about this a year ago (and you will see why I am delighted with the RCN’s vote of non-confidence, and why I am sceptical about his ‘apology’):

 https://onegpprotest.org/2011/01/22/an-attempt-at-transparency-from-andrew-lansley/

 One last thing. I would strongly urge any of you who really care about the NHS (as opposed to mouthing sound bites) to read the transcript of a recent lecture, and get the book it introduces. Then decide how you should vote.

 http://www.opendemocracy.net/ourkingdom/colin-leys/plot-against-nhs

 Best wishes,

 George

 The Tredegar Practice 35 St Stephens Road London E3 5JD

 www.onegpprotest.org

 http://twitter.com/#!/onegpprotest


My email to Liberal Democrat MPs

12/04/2011

 

Dear Liberal Democrat MPs,

I am a GP in Tower Hamlets. I am emailing all MPs, one letter at a time. I have managed only the A B & C’s so far. I am writing to you as a group before getting to the D’s because you seem to hold the power at the moment.

Most people seem to be focused on GP commissioning and future providers. These are important issues. I have focused on a policy which has received little attention: the proposal that English residents can register with any GP in England. I am told that all three main political parties support this polciy. It sounds like a good idea, what’s not to like about it? But it is vital that you look at the effects of such a policy.

If this policy meant that general practice in England (because Scotland, Wales, Northern Ireland are not proposing this) was, as a whole, undermined by this (became less efficient, more costly, at times unsafe), would you support it?

I have been a GP principal for 21 years. UK general practice is a wonderful thing, when done well. I am privileged to be in this job. I am spending hours writing to people like you because I believe that quality general practice is being eroded by successive governments.

If the KGB had infiltrated the Department of Health and the House of Commons, and if its aim was to undermine British general practice, then this policy (among others) might be the sort of thing they would try to implement. I offer this as a surreal metaphor. And yet this is how misguided this idea is.

I emailed Andrew Lansley a year ago to check if he really understood what this policy would do. Here is the exchange that followed:

https://onegpprotest.org/2011/01/22/an-attempt-at-transparency-from-andrew-lansley/

The New Labour government carried out a ‘consultation’ on this issue a year ago. This was a PR exercise which was full of distortions, inaccuracies, and omissions. The Royal College of General Practitioners submitted a response. Have you read it? If not, here is the link:

http://www.rcgp.org.uk/pdf/RCGP_response_DH%20-%20Your%20Choice%20of%20GP%20Practice.pdf

For more information, see my blog  www.onegpprotest.org

I understand that the convention is that MPs act on behalf of their constituents. I am not writing to you as a constituent but as a citizen who happens to be a GP. I do not expect a reply, but I ask merely that you check the facts so that your vote is not a blind act of obedience.

 Best wishes,

 George

The Tredegar Practice 35 St Stephens Road London E3 5JD

http://twitter.com/#!/onegpprotest