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At the heart of general practice since 1960

We need to stop the privatisation of GP services

Letter from Doctors for the NHS

We (Doctors for the NHS) have grave reservations about the ‘Doctaly’ service as reported in Pulse last week - a private GP company NHS GPs to patients who are prepared to pay a fee to avoid waiting.

Doctaly does not provide emergency treatment. It recommends you go to A&E for that. They also do not help with psychiatric complaints or chronic disease. They advise that you see your regular GP. This looks suspiciously like the reality of much private practice which cherry picks the easiest elements of care and leaves the rest to the public sector.

As a profession general practice is under immense stress with vacancies in many practices. Every GP does their surgeries, home visits, out of hours work and trains the next generation of doctors. It is a full workload.

Because of the funding shortage, which all elements of the NHS are facing at the moment, some GPs might be tempted to fill the holes in their funding by taking on this additional work.

Some people might view this as ‘privatisation by the back door’ but it is looking increasingly like the government is holding the front door open for it. The funding constraints may become too great and our fellow practitioners may be forced to adopt this way of working. Our greatest worry is that we are being forced regardless into a two-tier system, whether our profession wants it or not.

Unlimited access to a GP and all their services for under £140 per patient per year is fantastic value. We want to work with more GPs to help develop a better funded, more co-ordinated service and provide a positive alternative to the dismantling of services we now see. We ask our colleagues to join us here.

Yours sincerely,

Dr David Wrigley – GP, Carnforth, Lancashire

Dr Paul Hobday – Vice Chair, DFNHS; GP, Sutton Valence, Kent

Dr Peter Fisher – President, DFNHS; Consultant physician (retired)

Dr Eric Watts – Chair, DFNHS; Consultant haematologist, Brentwood, Essex

Dr Peter Trewby – Treasurer, DFNHS; Consultant physician, President of the Association of North of England Physicians

Dr Jacky Davis – Consultant radiologist, Whittington Hospital

Dr Colin Hutchinson – Consultant ophthalmologist (retired)

Dr Jonathan Dare – Retired child and adolescent psychiatrist, Kings College and Maudsley Hospitals

Dr Pam Zinkin – Consultant paediatrician, London

Dr Malila Noone – Medical microbiologist (retired)

Dr Cathy White – Consultant paediatric neurologist, Swansea

Dr Morris Bernadt – Consultant psychiatrist, London 

Doctors for the NHS

Dr Dinesh Silva, GP and co-founder of Doctaly said: ’Doctaly was created to connect patients and GPs and aims to provide an additional and accessible service to support NHS practices and patients. As a full-time GP, I was keen to find a solution that compliments my NHS practice and doesn’t work against it. Our trials have shown that both patients and GPs have welcomed the new service and we have had patients who have told us that if they hadn’t seen a GP via Doctaly then they would have gone to A&E.

’In relation to the suggestion of ‘cherry-picking’, this is simply not the case. We suggest that any patient with serious symptoms such as chest pain, severe pain, shortness of breathe go to A&E, in the same way that any GP practice would signpost potentially serious symptoms appropriately. It would be irresponsible and unsafe to suggest otherwise. We also advise against presenting with chronic disease problems and psychiatric problems as the most effective clinical management will be dependent on having a complete clinical history, which as of yet the GP will not have. We strongly believe that this is in the interest of patient safety and effective clinical decision making.’

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Readers' comments (12)

  • Slightly baffled why a large number of consultants are against this when consultants have been playing the long NHS waiting list v short private wait list game for ever. The only thing that has ever stopped this in GP land before is our biased contract

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  • It may come as a shock to all these consultants, but most GP Practices are private businesses who contract their services to NHS. I believe this to be possibly the most important factor that makes primary care so efficient. If I want to do some private work on a side, using doctali or not, it's my own business.

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  • Lets cut to the chase here. A thinly veiled moan that basically says "Please give us lots more money" isn't going to cut it. We would ALL like a "properly" funded NHS - but it isn't going to happen. Ageing and growing population, more expensive treatments, etc, etc, - times are a-changing and we can either moan, attempt to hold back the flood waters - OR look forward and try and find practical solutions that DON'T involve billions more of the taxpayers money. So lets please stop living in the past and look forward....

    Being a GP has steadily become less and less attractive as a profession - I won't pretend I don't regret my career choice on occasion - and this needs to change. If Doctally or similar offerings can help by offering more varied and better compensated conditions, we should all be supporting it - or at least giving it a chance before slapping a "Privatisation - HELL NO!" sticker on it.

    So lets cover your "greatest worry". Firstly, healthcare in this country has been a two-tier system for many years. Nearly 1 in 8 members of the public have some form of private health insurance so already "jump the queue". It is a fact of life that more money makes things easier/faster/better - in pretty much every aspect of life. To try and prevent this in health is a complete waste of time. We should be worrying about improving the standard for those who receive the worst healthcare treatment - NOT worrying about how those with money choose to spend it!

    "whether our profession wants it or not" - here is a thought. Instead of writing an open letter attempting to influence your fellow GP's, why not let them decide? If the profession doesn't want it, this company will fail - if it does want it, it will succeed. How about we allow individual GPs and the public decide?

    And finally lets talk about what ought to matter most (but sadly doesn’t always seem to) – the patients! Every single “queue jumper” is one more available NHS GP appointment for those who cannot or will not pay to see a GP. In the same way that people who choose private education are voluntarily choosing not to spend taxpayers money, this is no different. You want more funding for GPs?? Don’t you get it?………this model if it goes mainstream IS effectively more funding for GPs! Less NHS demand on GPs, shorter overall waiting times, a bit more money in GP’s pockets……..if the price we pay to achieve that is having to hold our noses at the “two-tier” service, I for one will do just that…….

    ……and anyway…..what's the alternative? Wait for Corbyn to be PM and flood us with funding…….hmmm………

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  • RE The first two comments - it is interesting to see that of the dozen signatories to the letter, only two are actually GPs. The rest already enjoy this type of model.......pot...kettle....black?

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  • think Doctaly is a great idea - good luck to him.

    he should be praised for raising the issue of the true cost of healthcare with the public. if anything the rates are a little on the low side but this is what is in store for the public should we have a private service. this is not a doctor vs government battle. the NHS is the public's and they pay for it. they need to decide what they want from it and if they are willing to pay for it. it isn't our battle - the NHS is just a system we happen to be working for.

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  • Please stop Privatisation of NHS.
    GPs are private providers.
    Please first rid of them by making everyone Salaried GPs who are employed by NHS.

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  • One working GP out of twelve. One retired. More opinion leaders telling GP how to run itself. Please stop doing this. Just keep your opinions to yourselves.

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  • Oh, I thought this was a call to end APMS contracts roll-out to replace collapsing GMS practices.

    Silly me.

    Our GP's are welcoming services like Doctaly, which, if successful, will see fewer coughs and colds and also some nonsense that does not warrant an appointment with the GP.

    We (NHS GP services) do not get paid by activity, so any displacement of activity away from the surgery is welcome. Aloows more time to concentrate on more serious matters.

    We have a few patients that use private medical services and they are an absolute joy to work with as we would not be able to accommodate their need for attention to every simple cut/scratch/cold/sore/red eyes/rash etc. But they fork out £110-£150 for the privilege to be triaged for 30 minutes by a private doc and bring us the "business end" of medical stuff that our GPs are more than happy to deal with.

    Cool thing about Doctaly, is that it gives any surgery an opportunity to pick up a bit of private income without the hassle of setting up a private GP service.

    It doesn't invent anything new, it creates competition to what's out there and the only losers are existing private GPs.

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  • Strangle the state system of funds. Wait for the demand for a "better " service . Supply a private service to those who can afford it and bingo- a private Health service . A tried and tested tory tactic.

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  • Bloody Tories! Insisting that as a country we should try and afford what we pay for. Boo!!

    The NHS as-was 60 years ago is on borrowed time. Lets wake up and deal with it rather than pointing fingers...

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