GPs in deprived areas are used to PCTs checking patients' addresses and removing suspected ghosts – often, it seems, without regard to accuracy or agreement with the LMC.
It leads to extra work at the practice, and it provokes resentment from patients, staff and doctors at practices.
PCTs do this because the Government seeks to save money, and the sort of patients who are wrongly removed from the list are often those least likely to vote. Politicians and managers justify their action and base their estimates of list inflation on figures from the national census. Unfortunately, however, the national census is an unreliable measure of the population, particularly in deprived areas.
After the 2001 census, GPs in our practice in a multiethnic area of west London asked 100 patients whether they had taken part in the census. Only 78 had done so. The others were, as you might suspect, concentrated among recent arrivals in the UK, those with limited English and those with mental health problems.
With the 2011 census fast approaching we need to do a much larger survey to ascertain how many do not take part.
The results will be important not only to GPs but also to PCTs and local authorities whose grant funding is adversely affected by overinterpretation of census findings.
We must suspect politicians and senior civil servants to wriggle all they can, so the survey needs to be well conducted and reported to journalists and opposition politicians as well as to the Government.
From Dr Alick Munro
Cranford, Middlesex
