Dr Zara Aziz: One size does not fit all

In the rush towards larger practices, the government is taking away patient choice, says Dr Zara Aziz.

Once upon a time, not so long ago I worked in a two-doctor practice, in a little picturesque mill town far, far away.

Between us we looked after 3,000 patients. I worked eight sessions a week - mostly sit-and-wait surgeries and undertook a home visit or two. I even had a lunch break. On Fridays this would be spent at the cafe round the corner, with our little team, as we closed the surgery for an hour during the middle of the day.

I sometimes wonder what criticism NHS England would have levelled at us with if they had known. Certainly our patients did not seem to mind. And, in any case, people knew where to find us in case of an emergency.

I now work in a much larger practice of around 19,000 or so patients. Our practice model works for our patients (and us), but this does not mean that one size can fit all.

I love my job, particularly the patient contact and the supportive colleagues who have now become friends. We are not the largest practice locally and daily I hear of either the closure of small practices like the one I used to work in or of their mergers into super practices.

I myself am registered with my family at a much smaller GP practice with personal lists. Two of my three children have asthma and have needed urgent care from our GP over the years. This has always been prompt and exemplary.

The little practice that I worked in no longer exists: the other GP has moved to Canada, the patients have been dispersed and the building converted into a launderette. The nearest GP practice is now an amalgamation of practices 15 miles away.

But does patient choice even matter to those that wield power in all of this? With the desire to control and dictate general practice (just like the rest of the NHS) and the push for financial savings, super-practices and seven-day working - regardless of what patients want -  it is choice that is being taken away from us all. But I hope that this will not be without a fight.

  • Dr Aziz is a GP in Bristol

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