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Battles still to be won on APMS

Pulse this week publishes a special report, ‘March of the private sector’ – and a march it truly is.

Pulse this week publishes a special report, ‘March of the private sector' – and a march it truly is.



Already a quarter of GPs have been approached by private firms with offers to sign up, according to our survey, and the number of PCTs tendering for APMS has leapt in recent months.

What once may have seemed a theoretical threat is crystallising into the here and now.

Pulse's survey – which received responses from more than 500 GPs – makes fascinating reading.

It suggests GPs are deeply sceptical about whether private competition will benefit primary care, but are resigned to co-operating with Government policy if it means safeguarding their livelihoods.

Only 19% of GPs support the Government's private sector drive in principle, but as many as 39% would work in a commercial health centre.

Pragmatic approach

Taking a pragmatic approach makes sense. All three main political parties in England support a role for the private sector, so APMS is not about to go away – GPs will have to find a way to live with it.

But that is not to say they have to like it. There's still no evidence for the benefits of independent sector treatment centres – the guinea pigs of private provision in the NHS – let alone for the APMS new boys. And there's a strong suspicion privately run health centres will be less cost-effective than mainstream general practice.

All of which leaves GPs in the tricky position of having to work with a policy that is untested, ill thought-through and potentially damaging.

GPs cannot win a battle against the Government's entire private sector drive.

But they can win individual skirmishes, particularly where there are proposals to force through polyclinics – most of which are likely to be privately run – without consulting local people.

The private sector may be on the march, but its momentum is not yet unstoppable.

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