The NHS Dominoes Are Falling, Is It Now Time for GPs?
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- Published: Wednesday, 24 August 2022 07:51
- Written by Peter Ingle
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Could family doctors follow dentists out of the NHS?
Many of those reading this will not remember “NHS glasses”. There was a time when primary care optical services were provided mainly within the NHS, by independent contractors.
Like dental care, spectacles and eye tests were free under the Health Service until 1951 when charges were introduced by the same Atlee government that had ushered in the NHS only three years before. Free eye tests for all lasted until 1988, when the dreaded NHS frames were replaced by a voucher towards the cost of glasses, but only for those in eligible groups. The arrival of the large optical corporates provided the appearance of choice and competition, and by and large the public accepted the changes.
Perhaps the general acceptance of these changes encouraged government to think that primary care dentistry could also be uncoupled from the NHS without political pain. Fast forward over thirty years and we are now watching the slow motion collapse of NHS dentistry in large parts of the UK.
The NHS retains a near religious place in the hearts of the population. The vast majority of General Medical Practice is still carried out under the NHS, with GP’s seeing patients many of whom may have adapted to making private arrangements for their optical and dental, as well as some hospital, care.
In Ambleside in the Lake district, the Central Lakes GP practice website carried shocking news for their patients recently. Alongside information about Covid 19 and encouragement to use the NHS App was the following announcement:
“Message to all our patients from Dr Paul Davies, Dr Kaye Ward and Dr Paula Cook. With much regret we must inform you that due to a number of factors outside the control of the Partners, we have resigned our General Medical Services (GMS) contract, handing it back to Lancashire and South Cumbria Integrated Care Board (ICB). This means that we will no longer be partners at the Central Lakes Medical Group and will be moving on in due course. Dr Kaye Ward and Dr Paula Cook will remain at the practice until 31st December 2022. The ICB will now begin the process of procuring a replacement and will be the point of contact for information or to answer any questions about next steps, they will be contacting you directly very shortly.
We would like to thank you for the support you have shown to colleagues and staff in the practice, particularly over the past couple of years during the pandemic.”
The same announcement on the practices twitter account provoked many comments. The vast majority were a mixture of the concerned, and those thanking the departing GP’s for their work. Digital Health expert and Medical Director Professor Joe McDonald simply tweeted “bloody hell, the first GP domino to fall.”
Dr Peter Weeks, a GP working at Morecambe Bay, added “A fab surgery in beautiful Lake district with amazing partners is no longer viable with current funding package, let that sink in. I know these GPs, they are superb+have done all they can+Thank you partners. Shame on those who haven’t allowed common sense/patient interests to prevail.”
William Greenwood Chief Executive of the Cheshire Local Medical Committee tweeted, “Such a sad end to the adventure. Unfortunately more to come. First NHSE oversaw the demise of NHS dentistry and now it’s the family doctor services.”
A GP partner at another practice commented that “none of us are far from this,” while another GP described the development as “a canary in the mine”
The day before the Central Lakes announcement the same NHS Lancashire and South Cumbria Integrated Care Board(ICB) had an announcement of its own. Four new directors of care and integration had been appointed for the area. According to the ICB each of the new directors “will be responsible for improving the health and wellbeing of residents”. The profiles of the four reveal that only one has had a clinical background, as a nurse, before moving on to the world of public health management.
Writing this a long way from Ambleside, in an area where local private hospitals already offer private GP services, it is possible see alternatives to NHS GP’s developing. As with optics and dentistry before, many of those who can afford the new private GP’s may gradually find reasons to switch.
The appeal of more easily available appointments, convenient times, being able to see a particular doctor and possibly a longer consultation, may add to the shift to private GP’s. In contrast, the future for patients unable or unwilling to pay to see a doctor, may become as bleak as the current situation is with NHS dentistry.
As doctors read the latest BBC research revealing that 90% of NHS dental practices are not taking on patients, some may be fearing a similar future for NHS general medical practice.
No Surprise There!
Successive governments have ceased to honour their contract with the public so private provision is inevitable.I rocked up at casualty with a detached retina. Sorry mate, you need surgery within 12 hrs to save your sight. We’re unable to help..told me to call back next week! Got it done next day privately for £10K so still able to practice! My macula literally came off as my wife & I drove into central London the following morning!
Anyone need regular blood tests? Turn up at phlebotomy & take a number? We’ll get to you when we’re ready & charge you £5 parking.
I pay £15 for a very gentle phlebotomist to rock up to the practice at 8.30 & take bloods for £15 - no cancelling patients & she drops the samples off at haematology too!
Need a GP? Hate playing telephone bingo at 8am with everyone else. I pay £100 for a 30 min consultation at the local Nuffield if I have a problem.
I’m just lucky I can afford it! Millions can’t.
It’s the same with police, social care etc..
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