Strike-off threat to 'competitive' GPs

Exclusive - DoH on collision course with profession over 'fair competition' definition. By Rob Finch.

Professor Steve Field

GP leaders are on a collision course with ministers after GPC and RCGP joint guidance suggested that GPs could be struck off if they actively competed for patients.

They have refused to budge from their 2002 pre-GMS contract position, which states that 'You should not go out and canvass or entice patients to join your practice'.

The new guidance, endorsed by the GMC and the central document underpinning revalidation, says that a GP's behaviour would be deemed 'unacceptable' if they were to contact prospective patients directly.

The news follows June's DoH primary care strategy, which said that ministers would promote 'fair competition' in primary care. It also follows comments by health minister Ben Bradshaw that 'gentlemen's agreements' between GPs were preventing patients moving practices.

GPC negotiator Dr Brian Dunn called for a clarification from ministers and the GMC on the definition of advertising. He said there was a growing 'clash' between GPs' personal and commercial responsibilities, which could result in a doctor being investigated by the GMC and ultimately, being struck off.

'Obviously government policy is about competition, but it should be up to the GMC to rule on what advertising consists of. It puts GPs in a difficult position,' he told GP.

RCGP chairman Professor Steve Field said: 'On the one hand we would support information given to patients through websites, but it's about objective information rather than saying "come down to this surgery because we're better".'

He added the RCGP was considering introducing guidance on advertising as part of the primary medical care provider accreditation scheme.

Dr James Kingsland, chairman of the National Association of Primary Care, said: 'We should all be able to publish information - say your practice leaflet - in council offices, job centres and so on.

'If your practice does this and another doesn't, that's their problem.'

The last GMC guidance to rule out 'claims of superiority' in GP advertising was withdrawn in 1997. The current 'Good Medical Practice' says: 'You must not put pressure on people to use a service'.

The new joint guidance 'Good Medical Practice for GPs' has been updated to reflect the demands of revalidation and the GMS contract.

The DoH said it had no guidance on advertising for GPs.

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