Partnership review chair rejects call for GPs to offer private services to NHS patients

GP practices should not be allowed to offer private services to patients on their own NHS lists, the GP chairing a review of the partnership model of general practice has warned.

Dr Nigel Watson (Photo: Pete Hill)
Dr Nigel Watson (Photo: Pete Hill)

Speaking at the RCGP’s annual conference 2018 in Glasgow, partnership review chair Dr Nigel Watson said he was ‘not in favour of charging patients’ and argued that doctors should instead be focused on securing increased resources to support a comprehensive NHS GP service.

GPonline reported last week that a New Forest GP had launched a legal bid to overturn part of the GMS contract that prevents practices from charging patients on their own NHS list for all but a handful of services. The doctor behind the challenge says the move could help cash-strapped practices avoid going under by providing new income - while helping patients access services they want, but which are not available on the NHS.

However, Dr Watson - also a New Forest GP - said he did not support the proposed GMS contract change, arguing that doctors should offer care to patients 'irrespective of their ability to pay'.

GP services

His comments came in response to a question from former RCGP First5 chair and Oxford GP Dr Shamila Wanninayake.

Dr Wanninayake said: ‘As young GPs we want to be able to be flexible and agile in how we deliver our services and part of the issues we feel is the fact that, actually, partnerships cannot do that. They are tied by quite a rigid contract that does not allow them to provide services that are currently… allowed to be provided by their local pharmacy [or] by other private providers.’

She added that a change to the GMS contract could help diversify primary care services and help GPs ‘take back some control’.

However, Dr Watson replied that he is ‘a firm believer in the ability of people to receive care irrespective of their ability to pay’.

‘I personally don’t think doing a legal challenge will sort out some of the issues we’re talking about. I certainly believe that we need more resources in general practice to be able to deliver it,’ he said.

Privatisation

He added: ‘I think if you go round the world there is very little evidence that charging patients improves doctor satisfaction or patient satisfaction. I’ve spoken to lots of doctors who have come back from New Zealand and Australia who will give you different views [but] I’m not personally in favour of charging patients. I think we need more resources. I think the risk is that the legal challenge hijacks the debate.’

The GPC last week confirmed its support for GPs to 'be able to provide minor treatments and procedures that are not available through the NHS'. GPC chair Dr Richard Vautrey said 'it would be reasonable to expect that patients would want to be able to get this service from their practice, from GPs they know, rather than having to be referred elsewhere'.

Although GPs are currently allowed to offer services privately, they are not allowed to do so to patients that are on their registered practice list - meaning patients must be sent elsewhere for treatments such as private vaccinations or minor cosmetic procedures.

If successful, the legal challenge could put GPs in the same position as NHS consultants, dentists or pharmacists who can charge their NHS patients for treatments over and above those provided by the health service.

Last week, interim findings from Dr Watson’s government-backed partnership review showed that factors undermining the GP partnership model are largely inseparable from the drivers behind the wider GP crisis - namely a declining GP workforce, rising workload and increased risk around premises and indemnity.

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