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Independents' Day

Competition regulator launches probe into GP services

Monitor has launched a major ‘exploratory exercise’ gathering evidence on patient access and competition in GP services to assess if they ‘are working in the best interests of patients’.

The regulator has launched a one-month public consultation that will gather evidence on whether patients are able to switch practices easily, whether they are open at convenient times and the rules for setting up/expanding a general practice.

Monitor - which has responsibility for regulating co-operation and competition in the NHS - said it will also consider evidence on the ‘different contractual terms’ under which practices operate and barriers to integration of care.

The call for evidence comes after Monitor’s ‘A Fair Playing Field’ report was published in March, finding ‘perceived conflicts of interest that may in future prevent clinical commissioning groups from commissioning services from new entrants’ and ‘concerns about a lack of choice of GPs for patients.’

The regulator said it will analyse all the responses received and publish a statement outlining the issues identified before the end of 2013, which will also set out what next steps it will take in acting on the evidence. But it also stressed that the consultation was not a formal enforcement investigation or a review of the quality of individual GP practices in England.

The consultation document said: ‘This call for evidence is an exploratory exercise aimed at better understanding the challenges faced by an important part of the health sector at a time when it is operating under increased pressure. It is not an investigation under our formal enforcement powers.’

Dr David Bennett, chair and chief executive at Monitor, commented: ‘For many patients, GPs are the first port of call when they access NHS services and general practice has a significant impact on the wider heath sector.

‘People want a good service from their GPs, they want to be able to see their regular doctor at times that suit them and they want to be able to make informed choices about their health care.

‘This call for evidence is an opportunity for Monitor to learn about any barriers preventing general practitioners from delivering what is best for patients.’

But GPC deputy chair Dr Richard Vautrey said: ‘I think it is actually very easy to switch practices and I think the reason not many patients do switch is because they are happy with their practice, as the patient survey repeatedly shows. I understand why Monitor has to investigate access, but I hope the conclusion is that there is no problem.’

‘I also think there are bigger issues preventing the setting up of new practices other than the rules. The main hurdle both to opening new practices or expanding existing practices is to find the funding to do so.’

Readers' comments (9)

  • Yet someone else attacking us. Makes the article on moving abroad increasingly interesting.

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  • Where we are based there is certainly no restriction on moving to another practice. The problem, in fact, is that they are just as stretched as we are, and crumbling under the increasingly stupid set of govt targets and funding cuts.

    Maybe the Competition Commission should look into the government. They could check whether there is adequate choice between the main parties and tell us if the govt is working in voters' interests.

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  • Legal aid in criminal cases is being restricted to large companies with government contracts, effectively removing consumer choice (everyone is innocent until proved guilty - but pleas of guilty financially advantageous to companies with contracts).
    Patients can - and do - change practices: surveys show generally high levels satisfaction.
    Why is "choice" so important in general practice - where it exists - but needs to be removed on financial grounds only from individuals suspected, arrested or charged with offenses which could ruin lives even when proved not guilty?

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  • Flawed model of investigation.
    This is a political sop to find something to beat us with and reopen the issue that patients in work wish to consult in the morning late evening and weekend.
    This works in a market economy by those organisations that do respond to the need being able to generate more profit.
    At the minute "extended hours" remuneration is a financial loss for the practices already hard pressed.
    I refer the competiton regulator to the "irish rover folk song containing a line "custom like yours I can get any day" in its context of no cash exchange no service.

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  • When we can behave like commercial companies then I'll happily accept any competition monitoring.

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  • I think that this is actually more about assessing how much choice a patient has and now much competition there is. At the moment it is clear that the patient doesnt have a lot of choice becasue all practices are stretched therefore I expect the recommendation to be that primary care is opened up to the private sector as that will increase bot choice and competition.

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  • In the USA, there is a huge shortage of GPs. They are training nurses to become GPs. A patient of mine was in a Florida Hospital for 6 hours recently. Charge $12000. You can go bankrupt if you get very ill in the USA. There is a world shortage of doctors - so let us not worry too much. It is upto us to stand up and say enough.
    Private medicine is bad for patients. The Daily papers, I hope, get what they want at least for a while. The proof is in the tasting.

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  • Lots of comment from Monitor about what patients want - surely in a financially strained NHS any assessment should be based on what patients need?

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  • This is probably the most fundamental and far-reaching document ever to hit NHS general practice; it will determine our future or lack thereof. This isn't just about convenience and switching practices. If they get their way it will mark the end of GMS and usher in time-limited contracts.

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