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At the heart of general practice since 1960

This burning madness

GPs' gatekeeper role is a thing of the past and they should now be known as ‘navigators', the RCGP is claiming.

Dr Mayur Lakhani, RCGP chair, told a conference last week the college was abandoning its description of GPs as gatekeepers because it had ‘negative connotations'.

He said the gatekeeping role was perceived as a paternalistic way of limiting access.

Speaking at the Joint Consultant's Committee Conference in London, Dr Lakhani said: ‘The GP now has to act as a ‘navigator' for patients accessing the health service.'

GPs and academics were divided over the decision.

Dr Laurence Buckman, GPC deputy chair, said the committee had not abandoned the description of GPs as gatekeepers.

He said: ‘I don't go in for all this semantic dancing.'

Professor Martin Marshall, professor of general practice at the University of Manchester took a similar line, arguing that gatekeeper was well understood. He said: ‘I think policy makers use it in a positive way.'

Dr Eileen Higgins, a GP in Choppington, Northumberland, said the term ‘navigator' was ‘over the top'.

She said: ‘I don't think a lot of the patients would understand it.'

But Dr Aziz Sheikh, professor of primary care research at the University of Edinburgh, said the idea of GPs restricting access to the NHS was outmoded. He said: ‘GPs are already navigators – facilitating access.'

Dr Lakhani's stance echoed comments made in June by Gary Belfield, head of primary care for the Department of Health.

Mr Belfield said: ‘By 2008 we will be moving from the gatekeeper to the navigator – it will be choice for patients in consultation with GPs.'

Navigator vs. gatekeeper

‘We aren't gatekeepers and

we never really wanted to be'

Dr John Grenville, secretary of Derbyshire LMC

‘I don't think a lot of the patients would understand the term navigator'

Dr Eileen Higgins, GP in Choppington, Northumberland

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