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July 3rd, 2008

Family doctors dislike government medicine

Posted by: Tim Castle

Health Minister Ben BradshawA simmering row between family doctors and the government has erupted after Health Minister Ben Bradshaw accused GPs of stifling competition by operating “gentlemen’s agreements” not to poach each others’ patients.

Laurence Buckman, chair of the British Medical Association’s GP Committee, told the BBC the claim was “absolute nonsense”, but then rather undermined his own argument by adding:

“Nor are we going to compete for patients, that is not the way general practice works.”

But that is precisely the way the government wants general practice in England to work in future. It wants to improve patient access to family doctors and believes offering the public a choice of GP surgeries will be a popular and vital element of its plan.

It has already arm-twisted doctors into agreeing to offer extra evening and weekend appointments and is building 150 polyclinics — now referred to as “GP-led health centres” — open early till late, seven days a week, where patients can get seen without needing to register.

“My view is you can compete and collaborate at the same time,” David Colin-Thorne, the government’s national clinical director for patient care, told a media briefing. “Patients need choice to drive up quality and for flexibility.”

Mayur Lakhani, a former chairman of the Royal College of General Practitioners, told the same briefing that his research into the medical experience of black and minority ethnic people had found they were afraid they would be struck off their surgery’s register if they complained about their GP.

When they did try to change to another practice, they were faced with a long list of questions asking why they wanted to move.

“That shows the big culture change we have to undertake. The receiving practice, instead of welcoming a change, were actually putting barriers up,” said Lakhani.

“I don’t think patients will change GPs and practices every six months, but I think the ability to do that is very important.”

Family doctors will come under greater scrutiny, with their surgery’s performance against quality standards and the views of local patients published on the NHS Choices website.

The government wants to sweep away the days of being stuck with an unsatisfactory GP practice. The question will be whether it can keep pumping in the resources — and keep doctors sufficiently on-side — to make sure there are enough GPs around for patient choice to become a reality.

June 12th, 2008

Polyclinics - are doctors lying?

Posted by: Tim Castle

benbradshaw.jpg

Health Minister Ben Bradshaw has used unparliamentary language to describe a campaign by doctors against plans for a network of 150 supersized surgeries — or polyclinics — across England.

More than 1.2 million people signed a British Medical Association petition that called for the government to support existing GP practices and to stop encouraging the entry of large commercial companies into primary healthcare.

Bradshaw said the doctors’ campaign against polyclinics was “misleading and mendacious”, a charge rejected by the BMA.

“If I were to run a campaign making false claims that something terrible was about to happen, a lot of people would sign my petition too,” he said.

The government says polyclinics will make it easier for patients to access healthcare by offering longer opening hours than existing GP practices, as well providing health services currently only available in hospitals.

It says polyclinics will not be imposed where they are not wanted and will not lead to the closure of traditional GP practices.

But doctors say polyclincs, grouping together teams of family doctors and nurses, will break the traditional relationship between patients and their GP.

They say commercial companies bidding to run these super-surgeries may put the interests of shareholders before the needs of patients.

Who do you believe - doctors or the government?