Remember all the trumpeting about being able to choose GPs, being able to control of our own records and all those good things that were just around the corner when Mr Lansley announced the liberation of the NHS in England in mid 2010? The public’s response to the consultation on being free to choose GP practices showed we were keen on the idea. But instead of a big leap forward for patient choice, what Mr Lansley announced this week when he stood in front of GPs at the National Association of Primary Care conference was a hesitant step. At least it was one in the right direction: pilots in 3 locations is better than inertia. It will happen through the agreement reached with the BMA’s General Practitioners Committee on a number of changes to the GMS contract for 2012-13.
Lansley backsliding on choice
Back in 2009 Mr Lansley’s commitment to eliminate practice boundaries was firm. They had to go because they were a “solid wall of defence against patient choice” They still are in our view. Now, it seems, he thinks they need to hang around – albeit in a more “stretchable” form. Whether this is a policy U-turn or a prudent change of mind depends on your politics, but either way it’s explained, the end result is a long way short of the expectations from 2010.
MAC always welcomes opportunities for making more informed patient choices. So we support the announcement, even while being disappointed in its scope.
Positive spin on not very much
Here is how the Department of Health explained the changes with the best spin they could muster.
Greater patient choice
Three areas will run the pilot from April 2012, which will see people having greater choice and flexibility about the GP practice that provides their personal care. It will mean patients are able to register close to work, close to a relative they care for or even close to a child’s school. The pilots will also test new arrangements to enable patients who are away from home to use a GP surgery as a non-registered patient.
Seventy-five per cent of patients who responded to a recent consultation on GP choice made it clear that they wanted greater ability to register with a practice of their choice.
The settlement provides the opportunity to fully test and evaluate the impact of increasing choice in pilot areas and will inform and strengthen proposals before wider implementation is considered.
End to patients being forced to de-register from their practice
The agreement today will also mean that people who move house just a few miles down the road will not be forced to move practice, which they would have had to do in the past. This will benefit up to three million or so people who move house each year within a short distance.
Hooray for 1948
Better than nothing, but nothing like bold enough to reflect the strength of public opinion about the need for choice of GP. That’s our verdict. But once the foot is in the door, there is the opportunity to kick it open wider.
There is a good precedent for offering choice of GP. When the NHS began in July 1948, a leaflet was sent to every household and on page 2 members of the public were invited to “first choose your GP”. Good advice doesn’t date.
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