Patients petition to keep local practices

Nearly 4,000 patients supported GP's Valuing General Practice campaign. Neil Durham assesses the survey's results.

If Gordon Brown were ever in doubt about the value of general practice, he would do well to read the evidence GP has gathered.

GP launched its Valuing General Practice campaign on 2 May and in the last 140 days it has received widespread backing.

A total of 3,980 patients filled out petitions in practices to lend their support.

Emails backing the campaign or expressions of support were received from 285 GPs.

Both the Liberal Democrat and Conservative shadow health secretaries have pledged their support in recent weeks.

Our campaign has revealed that patients and GPs are united in opposition to potentially expensive reforms they fear will sweep away the best elements of a highly valued service.

One GP said: 'Polyclinics could be a wasteful use of resources. A lack of continuity of care may lead to over-prescribing and over-investigation.'

Another asked: 'Is it cost-effective to open these polyclinics?'

Cost is certainly a concern - PCTs will be forced to raid existing budgets to pay for the new centres. The one-off lump sum of £250 million in DoH funding for 100 GP-led health centres in under-doctored areas and a further one in each of England's 152 PCTs is not enough to cover their total set-up costs. There are no plans for recurrent funding to support the centres, either.

Abandon polyclinics
The vast majority - 92 per cent - of 276 GPs who took part in GP's Valuing General Practice survey thought that the government should abandon polyclinics until the idea had been successfully piloted.

'All of medicine is now evidence-based. There is no current evidence base for polyclinics and so rolling them out across the UK before piloting goes against the scientific nature of medicine,' one GP wrote.

Another said: 'There have been too many expensive reorganisations. General practice provides excellent value for money. If polyclinics devalue it, GPs generally will be blamed.'

GPs are worried that shifting services into polyclinics could put patients at risk, too.

Some 90 per cent of GPs who took part in our survey said continuity of care would be damaged by government reform.

'We are a rural practice, a lot of patients would find it difficult to attend a surgery further away and home visits would increase,' one GP said. Another said: 'Elderly patients couldn't travel to the polyclinics without a lot of hassle and discomfort.'

If their practice closed, 93 per cent of GPs thought patients' health would suffer.

One GP said: 'I think a lot of our patients would be bewildered and disappointed, and be deterred from going to the doctor's at all.'

Another GP added: 'The main users of general practice are the young and the elderly. Not all have access to a car or public transport, and parking in town centres is expensive.'

GPs on polyclinics
GPs voice their opposition to the government's polyclinic plans

"Polyclinics could be a wasteful use of resources. A lack of continuity of care may lead to over-prescribing and over-investigation."

"All of medicine is now evidence-based. There is no current evidence base for polyclinics and so rolling them out across the UK before piloting goes against the scientific nature of medicine."

"The main users of general practice are the young and the elderly. They would have to travel further; not all have access to a car or public transport, and car parking in town centres is horrendous and expensive."

Patients' views
Practices collected signed statements from thousands of patients who explained why they valued general practice.

General practice is clearly getting the basics right, with comments including: 'I value that I am not just a number. I am someone to my GP surgery. It is a familiar face that cares. Britain needs to stay caring and not faceless.'

One patient pleaded: 'Please do not introduce polyclinics. I want our family to be treated as people, not customers.'

Continuity of care and a service close to home were among the key factors patients fear will be undermined by a shift to polyclinic-style healthcare.

Patients' tributes to GPs

Personal care and convenience were highly valued by many

"I value that I am not just a number. I am someone to my GP surgery. It is a familiar face that cares. Britain needs to stay caring and not faceless."

"Please do not introduce polyclinics. I want our family to be treated as people, not customers."

"I have been here over 40 years. It is a lifesaver for me. It would be a disaster if it were to close. This is a superb surgery."

"Cherished confidential doctor-patient relationship which I fear could not be replaced."

"Been at surgery since 1959. Excellent service and care. I do not want to travel at 79 years."

"Because I trust and respect my doctor, they know me and my problems and it's always a great service."

"The practice is very local and as a single mother with no car I appreciate the closeness of the practice to my house."

One wrote: 'I don't want an impersonal service with someone I don't know and cares less. Here we have a good quality service.'

In some cases patients felt that they owed their lives to general practice. 'I have been here over 40 years,' said one. 'It is a lifesaver for me. It would be a disaster if it were to close - this is a superb surgery.' Another said: 'Extremely good GP service. I wouldn't be here if they hadn't cared for me so well!'

A consultant's kind words show the value that the rest of the NHS places on GPs: 'Please keep local GPs. As a hospital doctor I often found the GP can provide the best background information about patients, having known them for years. The information that GPs have is invaluable.'

Some patients said the government should be 'ashamed' about its policies. 'We have an excellent service from everyone here. This surgery is an absolute necessity as we get older. Leave us alone please,' wrote one.

Will Gordon Brown take note?

neil.durham@haymarket.com

Visit our online Valuing General Practice resource centre, which includes an archive of articles relating to the campaign, at www.healthcarerepublic.com/value

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