NHS England refuses to rule out 'free school'-style GPs

NHS England's chief executive has refused to rule out introducing 'free school'-style GP practices that would compete with existing surgeries and be paid according to how many patients they attract.

Simon Stevens: free school-style policy for general practice
Simon Stevens: free school-style policy for general practice

In a testy exchange at a House of Commons health select committee hearing on Wednesday, Simon Stevens was asked about past comments suggesting education secretary Michael Gove’s ‘free school’ policy could be applied to primary care, with GPs competing for patients.

Writing in the Financial Times in 2010, while president of global health at US private health firm UnitedHealth Group, Mr Stevens called on NHS England to ‘think radically’.

He wrote: ‘Will it, for example … apply education secretary Michael Gove’s "free schools" policy to primary care, opening up underserved parts of the country to any willing provider, whose reimbursement would depend purely on whether patients voted with their feet to join the new practice?’

Pressed by Valerie Vaz MP (Lab, Walsall South) on whether he intended to introduce such a policy now he was leading NHS England, Mr Simons would not give a yes or no answer.

Patients already choose their practice which partly determines funding, he said. ‘Whether you choose to call that competition, or not, that's just a basic patient entitlement.'

Funding depends on patients

Primary care is ‘absolutely foundational', said Mr Stevens, but in order to develop out-of-hospital care we have to ‘make sure GPs have got the resources they need, and that we do primary, and community and social care in a different kind of way’.

‘I'm open to all kinds of ideas as to what that should look like,' he added.

Ms Vaz asked: ‘So you're not ruling it out then.’

But Mr Stevens replied: ‘I'm not quite sure what the "it" is.'

Most GPs are independent contractors in law, explained Mr Stevens, ‘so to the extent that what we are talking about is giving GPs more flexibility to shape services, budgetary clout to do so, the ability to work more closely with community health services, developmental health services… All of that stuff, absolutely is the conversation we will be having.’

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