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At the heart of general practice since 1960

Why GPs will no longer have a choice over Choice

Whenever the Department comes up with a new wheeze designed to make that well oiled machine called general practice just that little bit more effective, we always make sure that we get reaction from a good cross-section of GPs.

By Steve Nowottny

Whenever the Department comes up with a new wheeze designed to make that well oiled machine called general practice just that little bit more effective, we always make sure that we get reaction from a good cross-section of GPs.

And while the general reaction is all too often outrage, two years at Pulse have taught me there are degrees of GP outrage. Some initiatives prompt a mere world-weary eye-rolling – others a small explosion at the other end of the phone.

Reaction to our report this week that offering patients choice could become part of the core GP contract was definitely near the apoplectic end of the scale. Put it this way – when senior GPs with decades of experience start using the f-word to express their frustration, you know it means trouble.

This week, the outrage came in three flavours. First, there was general resignation at yet another initiative designed to micromanage how GPs care for patients. The Govenrment's impact assessment states that if GPs are to offer their patients choice in person, they should spend a maximum of one minute in each consultation doing so. Not only is this unrealistic, said the GPs I spoke to, it's none of the Government's business.

Second, there is huge frustration at the need to offer choice at all. Time and again, GPs have argued that with the exception of a small, informed minority whom they are happy to accommodate, patients don't want choice. And outside major cities, geography means they don't have much of one anyway.

But the biggest objections came when GPs considered why the Government would want to put choice into the contract in the first place. After all, the NHS Constitution will make it a legal right anyway, so isn't putting choice into the contract just dotting the I's and crossing the T's?

Well… not really. The real reason the Department is so keen to make offering choice a contractual requirement is so it can act as a lever for PCTs struggling to enforce the constitution's aspirations. Taking legal action over the failure to offer choice is a theoretical possibility which may one day happen – but giving trusts a contractual mechanism whereby they can easily impose sanctions, financial or otherwise, is much more effective.

That, then, is why the Department wants this – and why so many outraged GPs will be urging the GPC to fight it tooth and nail. Watch this space.

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