Patients to get the freedom to shop around for a GP

By Daniel Martin for the Daily Mail
Updated: 17:00 EST, 19 September 2009

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New power: Patients will have the right to register outside current boundaries

Patients will have greater power over their choice of GP and be able to ditch doctors they are not happy with under reforms announced today.

Health Secretary Andy Burnham also pledged that practice boundaries will be removed within 12 months.

Under current guidelines those living outside a certain area are banned from registering with some doctors, leaving patients with little or no choice over which GP they can visit.

The reforms mean patients will find it easier to move to a GP surgery nearer work instead of one near their home, or to register with a surgery in a more affluent area where services are better.

Mr Burnham hopes the fear that they could see patients leave in droves might prompt bad doctors to improve their service - especially as the fewer patients they have, the less government funding they receive.

The plans were welcomed by patients groups and opposition parties, but they were criticised by the British Medical Association, the doctors’ trade union.

In a speech this morning at the King’s Fund think tank in London, Mr Burnham said: ‘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. A busy mum needs flexibility - she may want to register at a practice near her children’s school.

‘Equally, a commuter may want to register near to work. I want them to be able to do this whilst ensuring that access to home visits won’t be affected, wherever someone ends up registering.’

He went on: 'Within the next 12 months, I want to abolish practice boundaries for patients to allow people to register with the surgery of their choice.

'That may mean a practice near work, or in their local neighbourhood from which they are currently excluded by dint of their postcode.

'But it means that their practice is based on their own needs, not by lines on a map or what is easiest for primary care trusts.'

Michael Summers, chairman of the Patients’ Association, said: ‘The lifting of these restrictions will be a boon for patients.’

Tory health spokesman Andrew Lansley said: ‘We’ve always argued that it was ludicrous for the Government to talk about giving people a choice of GP when they restricted that choice based on their postcode. That is why we announced plans to abolish practice boundaries two years ago

'We need to remove the perverse disincentives that currently exist which dissuade doctors from taking on new patients.

'We also need to give GPs much greater responsibility for managing their patients' care when they refer them on for hospital treatment, including control of the money that funds that treatment.'

Dr Laurence Buckman, chairman of the BMA’s GPs committee, said: ‘Major logistical barriers would need to be overcome for patients to be able to register with practices a long distance from home. Home visits with a GP a long way away would become difficult, and costly for the NHS to fund.

‘Practices in rural and suburban areas could lose significant numbers of young, healthy, patients, destabilising their funding and threatening their viability.

'Meanwhile, city centre practices would be inundated with requests for appointments at lunchtime and evenings, which would effectively limit patient choice.'

It emerged yesterday that GPs' pay has fallen slightly over the past year, from an average of £107,000 to just over £106,000.

However, there are still 260 family doctors earning more than £250,000 - the same number as a year ago.

The NHS Information Centre would not reveal how many of these enjoyed salaries of more than £300,000 - although it confirmed that some GPs earn that much.

Mr Burnham also announced plans to change the way hospitals are paid, which will see pay linked to surveys of how patients rate their care.

Questions will include the way patients are spoken to by staff, clinical quality and whether the patient is treated with compassion and respect.

Mr Burnham said: 'I want to see payment linked to levels of patient satisfaction through a powerful, new financial framework that rewards people-centred service and care.

'At the moment, quality is only faintly recognised in the tariff. In the future, we'll progressively link a much bigger proportion of a Trust's income to quality and, importantly, levels of patient satisfaction.

'This is a big culture change for the NHS, which has traditionally been paid by volume.
But my judgment is that the service and its staff are ready to make this change.'