Practice boundaries an anachronism according to King’s Fund?



One of the things that has puzzled me about the Choose Your GP Practice issue has been the almost total lack of challenge from the journalists reporting the various ministerial statements on this issue. I have seen no articles commenting critically on this policy. This is strange because it is such a crackpot policy. I was aware that Andy Burnham gave a speech in September 2009 on this. I tracked it down: he addressed The King’s Fund and, according to the Guardian he said this about choosing your GP practice:

“In this day and age, I can see no reason why patients should not be able to choose the GP practice they want. Many of us lead hectic lives and health services should be there to make things easier.”

I have listened to the the 51 second video segment on the Guardian page. He does not seem to understand how general practice works, or why there are practice boundaries. His arguments are quite arbitrary and irrelevant. I wondered how this ‘important speech’ was received at the King’s Fund. The video of the full speech is thankfully available from the King’s Fund along with panellists’ responses to the speech. Unfortunately, in the available video footage there is no mention made of GP boundaries.

However, in his closing remarks the chief executive of the King’s Fund, who I believe had chaired the meeting, had this to say:

On the plan to make it easier for patients to choose their GP, Niall Dickson said: ‘The vast majority of patients are more than happy with their GP, but the restriction on where they can register is an anachronism and the government is right to sweep it away. There are details to be worked out, but it should not be impossible.’

Anachronism? I would like to know in what sense. ‘Details to be worked out’? I would be curious to know what Niall Dickson had in mind.

I wish I had been present for this speech and discussion. I would have like to have asked the audience if they all agreed with this, check if there were any dissenting voices. And if not, suggest that if they really want to warrant the name ‘Think Tank’ that they do some homework and think this policy through.

The King’s Fund says this about their role and aim:

The King’s Fund is a charity that seeks to understand how the health system in England can be improved. Using that insight, we help to shape policy, transform services and bring about behaviour change. Our work includes research, analysis, leadership development and service improvement. We also offer a wide range of resources to help everyone working in health to share knowledge, learning and ideas. 

Niall Dickson is no longer at the King’s Fund. He is now in charge at the General Medical Council. I emailed him there, asking for clarification though I think I will not receive a response. I emailed the King’s Fund a week ago asking for their views on practice boundaries, and how this might affect the health system in England. I await their response.