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Letter of the week: Scrapping boundaries is stupid and dangerous

The Government's plan to abolish practice boundaries is a grotesquely stupid policy, and multiple problems will quickly emerge if it implements it.

Government to make GPs a ‘feasible offer' on abolition of practice boundaries

I am a GP in Tower Hamlets, and over 20 years we have seen  the problems that emerge when patients live at a distance from us. That is why we are firm about the practice area. Patients at a distance do not use us appropriately and do not get proper care when ill. At times it is dangerous.

Having a visiting service – a so-called daytime out-of-hours service – does not really solve the problem, as out-of-hours systems are just bridging strategies, and patients are always told to contact their GP in the morning if there are problems.

The physicist Richard Feynman said: ‘For a successful technology, reality must take precedence over public relations, for nature cannot be fooled.'

The politicians and planners and doctor-preneurs are ignoring the realities of the complex technologies of quality primary care in England, and are basing their policy more or less wholly on the question of ‘patient choice'. This choice is only an illusion.

A few relatively healthy patients may benefit from this policy, but the majority will not, and it will undermine quality. If someone actually wanted to introduce design faults into the system to make it work less well, this is what it would look like.

From Dr George Farrelly
Tower Hamlets, east London

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