My warning to Jeremy Hunt on the dangers of abolishing GP practice boundaries, 3rd attempt


Dear Jeremy Hunt,

I sent you emails on 8/9/13 and 13/10/13 warning you about the problems associated with a Coalition Government proposed policy. Consider these ‘complaints’, ‘whistleblowing’. The replies I have received do not in any way address the concerns I raise. You have said that hospitals need to address complaints transparently and be responsive to members of the public, that problems should not be hidden. You have said that staff who neglect patients’ safety should be liable to criminal prosecution.

So far you have evaded the issues I have raised in my previous emails. I am saying that this policy is unworkable, that in some cases it is unsafe; overall, it will impact negatively on the functioning of general practice. If harm comes to patients because of this policy and you and others have wilfully neglected a proper risk assessment, will you be accountable?

I require the following by way of response:

A. I challenge you and your officials at the Department of Health to respond, point by point, to my submission to the Health Select Committee.

B. In the Department of Health’s media launch of the so-called ‘pilot’ in December 2011, we read: “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.”

This detail of families registering at a practice near their children’s school is repeated in the evaluation Proposal submitted by Professor Mays in May 2012.

So you think this is a good idea? I challenge you and your associates at the Department of Health to answer the following questions about this particular idea:

1. What benefit accrues to a family if they register with a practice near their children’s school? Why would they want to do it?

2. How would this work practically? (Details please, full details of the mechanics of this).

3. Are there any risks or problems with this proposal?

Perhaps journalists can have a go answering these questions; and Andy Burnham; and Stephen Dorrell and his colleagues on the Health Select Committee.

Come on, have a go. Let’s see if the emperor is wearing any clothes.

Yours sincerely,

George Farrelly, GP

The Tredegar Practice
35 St Stephens Road
E3  5JD

Resident in London N7

Exclusive: ‘DH leak reveals uncertainty over 11,000 PCT jobs’


I have just read a Tweet that directed me to an article in the Health Service Journal. As a GP, I really have had no exposure to this publication, but because my wife is, as a CCG member, a subscriber, I have had a look at the online article. For those of you who have a subsciption, the link is

What caught my eye was an online comment (and there are many). Of course it was anonymous, it would have to be under the circumstances. I will quote it, and hope the publishers of the HSJ do not mind. I have had to type it out manually as the cut and paste function does not seem to work (have they somehow disabled this?):

The trouble is that so many people are just trapped, however much they’d like to leave. It isn’t just pensions, it’s families. Not everyone can hopscotch across the country, and relocate every time there’s a reshuffle. And not everyone wants to live out of a suitcase as a consultant. Much as many people hate the drip drip drip atmosphere of low morale, uncertainty, bullying, witchfinders in HR, the top down culture, the erosion of pensions and wages–the list is endless–not many have a choice. And that’s the worst thing of all. Subjecting a system to relentless change with no thought of humanity or the impact on individual lives creates something where people just become good at survivial. And that is soul destroying.

I left 3 years ago when I hit 40 because I saw how poorly many people I’d admired and looked up to were treated when their faces didn’t fit with the new power barons or they wanted to retire early or they got ill, and I didn’t want to be in that situation in my 50s. Having put up with appalling behaviour that wouldn’t be countenanced in the private sector–bullying in the NHS is so systemic people almost expect it as part of the culture. I knew if I left it too late my chances’d be slimmer because the age profile is very different in industry, but I still work with the NHS and my heart goes out to everyone going through all this, many of whom I’ve known for > 15 years. It’s difficult everywhere–I’ve been made redundant but secured work again–and this is all going to get a lot worse as we get into the new financial year and the scale of redundancies becomes clearer.

Or is that the plan? The NHS implodes, no one wants to work in it and we have the insidious creep of privatisation like dentistry and opticians?!


I’ve delayed going to bed (it is now 23:40) in order to type this out. I’ve had to create a new category: Collateral Damage. Best wishes to the author of this comment and the authors of the other comments to this article.

There are many important things in this comment. I will mention one: ‘not many have a choice.’ How ironic: the DoH and Government want to offer ‘choice’ to all and sundry, and yet the people shovelling the shit have ‘no choice’.

I have assumed that the crap coming out of the DH was not the work of everyone in that organisation, but the wishes of a few ‘power barons’. And that there are a lot of people just trying to survive. Best wishes to those trying to survive, and a curse on the ‘power barons’ and the bullies, and the politicians who collude with all of this.

Good night to all people of good will.