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Competition plea to help deprived

Competition in primary care is needed to stop patients in deprived areas being 'chained' to poorly-performing practices, Tony Blair's former health advisor has said.

Professor Julian le Grand, professor of social policy at the London School of Economics, said in a monopoly providers could ignore the complaints of users 'with relative impunity'.

Speaking in a recent lecture defending the Government's choice plans, he added GPs found it easier to deal with middle-class patients than those from deprived backgrounds.

While middle-class patients already had a strong 'voice' and were better at manipulating the system to their advantage, more deprived patients would be stuck with their practice in the absence of competition.

'Chaining people to their local GP practice, hospital or school meant that providers who offered a poor or tardy service could continue to do so with impunity,' he said.

Dr Charles Simenoff, a GP in Manchester, said Professor le Grand was right that GPs empathised more with middle-class patients, but that did not alter how patients were treated.

He said: 'There's a difference between empathising and doing a professional job.'

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