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Gold, incentives and meh

Health minister blames GPs for failing to offer patients choice - and claims 'many doctors take any excuse to keep appointments as short as possible'

A health minister has accused GPs of undermining the Government’s choice agenda by keeping appointments ‘as short as possible’ and taking the ‘easiest’ option of sending patients to ‘tried and familiar secondary providers’.

Speaking at a Westminster Health Forum event on the future of the NHS, Earl Howe said choice remained an important principle for patients, but there needed to be a ‘cultural change’ among clinicians.

The health minister told delegates that Choose and Book had not taken hold in the system, and blamed GPs for not pointing patients towards the scheme. He said that NHS England was looking at new ways of making providing choice ‘real’.

Earl Howe said at the event: ‘We are not doing enough to address the choice agenda. I think everyone believes in it – it is enshrined in the NHS Constitution. Patient choice is important. It is often said to me “not everyone wants choice”. And that is true. But we know that a lot of people value choice – it is one way of empowering patients.’

However, this was been undermined by clinicians, he warned. He said the choice agenda was ‘a cultural change’.

He added: ‘There are many doctors who take any excuse to keep the appointments with their patients as short as possible and to direct them to the tried and familiar secondary care provider because that is the easiest way to proceed.’

‘It is not doing the patients a favour and we will see in the information coming out of patient questionnaires the extent to which choice is being offered and that I hope will drive a push from NHS England and CCGs who have to demonstrate in the way that they operate that they are living by the letter and the spirit of the agenda.’

Earl Howe said that Choose and Book had not shown its full potential. He said: ‘We had things like Choose and Book for some years, but it has not taken sufficient hold in the system. There are many GPs who don’t point their patients to Choose and Book. We are actively addressing that at the moment, actively updating it, which we call the e-referrals system, so that it does provide a richer choice for patients at point of referral. We are also looking at other ways to prompt patients to be aware they have choice, to promote the NHS Constitution.’

NHS England is looking at ‘all sorts of mechanisms… to make the choice agenda real,’ Earl Howe added. ‘I think we will see some announcements coming out in the next few months.’

Last year, a wide-ranging DH initiative to force GPs to engage with the choice agenda outlined proposals to force practices to adopt ‘labour-intensive’ alternatives if they refuse to use Choose and Book. The electronic system for booking appointments is to be relaunched, based on the design of a flight booking website.

Readers' comments (49)

  • Earl Howe, sit in with a decent GP for a minimum period of three months or keep your stupid mouth shut!

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  • I am not going to post what i am thinking as it would be moderated off!!!

    It would be funny it they weren't so dangerous.

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  • Is this true? Can a health minister really be so woefully ill-informed and happy to display his ignorance. Has he really no conception of the pressures under which NHS GPs have to consult?

    As for "there are many doctors who take any excuse to keep the appointments with their patients as short as possible and to direct them to the tried and familiar secondary care provider because that is the easiest way to proceed" - I'd like to know on what evidence he is basing this allegation and conclusion. If, as I suspect, none, he should retract the statement and apologise forthwith.

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  • I'm for choice,who isn't.
    I want a choice of an NHS provider. My GP out of hours service only allows me Harmoni(now care UK)
    When will my local CCG give me a 'choice' ?

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  • Let's see his independently-commissioned evidence for these comments.

    Otherwise, he makes himself look highly ignorant, and frankly - stupid.

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  • Dear me. Our own fault for not defining safe consultation times and numbers. Choice - what choice ? Do not refer is the dictum - contrary to the patient Charter which states the patient has a right to a second opinion. We refer too many people, they keep on telling us. We do not spend any time with them. We play too much golf. Is this not so silly ? Is it not time to leave ? At least the Dentists saw this rubbish coming and left. GPC - ask the profession what they want, please.

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  • If I had a man like him in my consultation, of course I'm going to use any excuse to cut it short. I'm only human, not a saint!

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  • It is worrying enough if the man has some hidden agenda and knows what he is doing. But it is even more worrying if this is his true judgement.

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  • Who is Earl Howe?

    Educated at Rugby School then went to Oxford University (where he studied Latin and Ancient Greek) after that he went to work for Barclays Bank Plc 1981-87 (age 30-37 years) and then Adam &Co.Plc (a Private Bank) 1987 - 90 (aged 37-40) Got in to politics on account of his hereditary title (Earl Howe) - he is not a democratically elected politician - he sits in the house of Lords because he has an hereditary title.

    He has a broad back ground in banking and since his 40s has been working for the conservative party in the house of Lords. He has never been democratically elected.

    I'm sure he's very skilled in how Westminster works and I'm sure he's a very wealthy man. I fail to see how he is in any way qualified to lecture on the ins and outs of a GP consultation…if he has ever been to a humble and lowly GP himself (he must have done) he is likely to have found the whole experience difficult as having your problems addressed with-in the confines of a 10 minute appointment must be very difficult to swallow for someone as important as him.

    Why are we been lectured to by people like this? He hasn't even been elected by anyone!

    I despair. None of the frustrations regularly expressed in the comments section of PULSE ever finds its way into the mainstream media. None gives a monkeys outside the confines of the profession. This is clearly evident when ever some rabid member of the public with an axe to grind finds a way of posting comments (see earlier)

    Few people in the political establish get it - we are being parasitised and used. I urge my colleagues to disengage, retire or quit their job if they can. I am sorry to those who cant.

    Clare Gerada's recent call for all GPs to become salaried is an admission that we can't win - if the general public feels it has a right to 24 hour 7 day a week on demand 'give me what I want' health care whist only paying for only a 3rd of it - expecting 'perfect Drs' to do it all for the price of a tin of beans - then thats what they will try and get. The only reason to stay in such a system is because of a religious like calling. I can respect anyone who feels like that but it isn't for me.

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  • Can you put me on the list for this health ministers 360 degree appraisal?
    Where does he get his data from?
    His great education in the humanities with speciality in Latin verse qualifies him for a job as health minister in what way?

    oops silly me, I forget, you do not need qualifications, nor experience, nor facts, and you do not get a performance review as minister.

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