Why I have fears around our new health secretary
Dr Kailash Chand
When he was appointed health secretary, Jeremy Hunt told parliament that he visited an A&E department as he ’didn’t want to wait’ for the GP surgery to reopen. In doing so, he sent the message to the public at large that it is acceptable for people to ’bypass GPs and go straight to A&E’.
History is repeating itself. Now we learn that newly appointed health secretary Matt Hancock is a signed up member of the Babylon run health-app that is threatening the existing model of general practice. It seems, Mr Hancock doesn’t believe in the need for a physical GP. At an event in Central London last month, Mr Hancock said: ‘I’ve signed up for Babylon Health so I no longer have a physical GP.’
Babylon now has several hundred GPs on its roster, working across its private and NHS services, remotely or from its London headquarters signing up several thousand patients. The new GP in Hand app undermines the basis on which GP practices achieve financial stability. Each time a patient registers with GP at Hand they become deregistered from their current practice, and the funding goes with them.
But there is also an equality of access issue. While anyone can join its service, the website says it may not be suitable for ’complex mental health problems or complex physical, psychological or social needs’. Or if you’re pregnant or older and frail, and as long as you don’t have dementia or learning difficulties or safeguarding issues.
We as GPs have experience the 80/20 rule - 20% of our patients need 80% of the work. This new service is cherry-picking its target population. GP at Hand is flawed in many other ways, including continuity when time and again the evidence shows that continuity is what patients cherish most.
Call me a luddite, but I remain convinced - no app or algorithm will be able to do what a GP does. Much of what GPs do is based on a trusting relationship between a patient and a doctor over their lifetimes, and my experience of 30 years in general practice has taught me that GPs have a ‘gut feeling’ around what is wrong with a patient.
I have other concerns around Hancock. He is also reportedly close to free-market think tanks like IEA. In a speech in 2012, he backed introducing an insurance system to fund social care. He voted to speed up privatisation of the NHS, by voting in parliament to lift the cap on how much NHS hospitals can earn from private patients. This allowed NHS hospitals to earn unlimited amounts from private work at the cost of neglecting the NHS patients.
After the disastrous run of Lansley and Hunt for eight years, I fear Mr Hancock is no different, just a change of guard. Can we trust a neoliberal, IT enthusiast, a supporter of insurance system for health care with our NHS or general practice?