Letter: Quality surveys do not measure quality

Dear Editor 

Matthew Hankins is absolutely correct in his assertion that the GMS surveys are not valid measures of quality (GP, 21 July).

These surveys measure impressions, not quality. Faced with a result that the impression is not favourable, a practice needs to alter the impression.

It might do this by altering the quality, but that is expensive, particularly if the quality is already good. A more realistic strategy would be to alter the impression by some sort of campaign - in effect, spin.

The government is in the business of winning elections, and it is impressions that gain points. Look at the reaction to Patricia Hewitt's remarks that the 'NHS has had its best year ever'. That is statistically true, but the impression is otherwise.

No, the idea of patient surveys is to turn GPs into paid spin doctors to convince the public that the NHS is getting better. The GP earns more money and the government a better chance of re-election.

We were able to demonstrate that patients would offer an opinion on subjects about which they had absolutely no experience (we did this by correlation of responses on the IPQ survey). We found that patients would answer with either some opinion from the popular news, or by repeating what we told them was the truth.

They would also answer questions such as 'The practice's respect of your right to seek a second opinion or complementary medicine was ...'

Surveys rate all of these responses equally when, in terms of clinical quality, they are not equal.

If Lord Warner wants to measure quality, he should set up instruments that measure quality, not impressions.

Our practice values surveys greatly and we will continue to use the IPQ, but they measure opinion, not fact, and the two should not be confused.

Dr Ken Holton, Coventry.

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