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Experts call for more evidence to back up move to new GP care models


The drive towards super partnerships and primary care at scale is as a result of the lack of investment in the backbone of the NHS. The lack of recognition of General Practice as a specialty in its own right is part of the issue. The public has yet to be formally asked if the direction of travel is the one they want. In my experience there are two types of patients, those that just want a quick fix and don't care who or where they are seen so long as it is timely and convenient. The second type is the patient who cherishes the continuity of care and the relationship they have with their GP. The two types are interchangeable depending on the problem they perceive to be sorted. Patients also only know two places to access care their GP or A+E yet we persist in commissioning every alternative to prevent access to either. The role of the GP has grown organically and what is provided is determined by the provider. General practice at scale is a way of standardizing what is provided at the cost of continuity of care. It suits some doctors to work in a salaried shift system for others it is the continuity and relationship of the fixed list, cradle to grave responsibility that matters. The business models are flawed to provide the NHS because it is a socialist ideology. The public perceive it to be their right to access every level of care because that has been the political promise to them. What has never been discussed is how it is paid for and by whom. Rationing and co-payments started in 1949 which led to Bevan's resignation yet the mere mention of either is political suicide. There needs to be a proper conversation and a truly national standardized service where the public knows what is and is not available. The models that are being imported from the US don't take into account that they only work because the patients through their insurance schemes have personal responsibility to use their system appropriately or pay more. The insurance companies squeeze the providers so that care is rationed depending on the policy.

Posted date

21 Feb 2018

Posted time