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Specialists refuse to co-operate as GPSIs cut referrals to hospital

GPSIs face rebellion from consultants


The Government's drive to shift work into primary care using GPSIs is meeting strong resistance from consultants, with some now withholding their co-operation, Pulse can reveal.

In more than half the areas where GPSIs have been introduced there have been sharp falls in hospital referrals, with some consultants facing job losses as a result, our investigation found. Some 80 per cent of consultants surveyed said they were unhappy with the way schemes had been set up.

For the first time concerns were raised outside dermatology, with specialists in cardiology and diabetes also voicing doubts over the GPSI drive.

GPSIs told Pulse they were facing increasing resistance in trying to set up services as consultants decided it was not in their interests to co-operate.

Dr Richard Motley, consultant in dermatology at University Hospital of Wales in Cardiff, said there was 'real concern about specialist units being closed' across the UK.

'We have not co-operated with establishing GPSI services. I've heard of consultants being asked to take unpaid leave as a result of contracts being offered to entrepreneurial GPs.'

Dr Robert Macfadyen, consultant in cardiology at City Hospital in Birmingham, said: 'Why should PCTs have a role in something they have never provided? Specialist GP is an oxymoron. How can a generalist with no or minimal specialist knowledge be a specialist?'

A GPSI in ENT who wished to remain anonymous said relations were strained with consultants in her area: 'This is developing more and more. They feel like it's the beginning of the end of the NHS.'

A second GP, trying to set up a GPSI service in diabetes, said she had experienced 'big variability' in co-operation.

Respondents from 22 of 31 hospitals had a GPSI service in their area – but only about a quarter felt it possessed sufficient expertise to deal with its caseload. Three said they could face redundancies.

Dr Colin Holden, president elect of the British Association of Dermatologists, said it was aware of 'widespread anxiety' among dermatologists.

But Dr Stephen Kownacki,

a GP in Wellingborough Northamptonshire, and president of the Primary Care Dermatology Society, said consultants might face independent firms taking their business if they didn't co-operate with GPs.

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