General practice is ‘not a massively profitable area at the moment’, according to health minister Lord Markham.
His comments came during a debate in the House of Lords yesterday, which focused on the risks of GP practices being bought by US companies.
He also cited GP service provider Babylon as one of the examples of the companies who ‘did not manage to make it work’.
Lord Forsyth of Drumlean asked the minister if there was a risk of private equity ‘buying up’ general practice, as he said happened with veterinary services.
He said: ‘If we look at what has happened to vets, for example, private equity has bought up veterinary practices and prices have gone through the roof in order to pay for the funding costs. If this were to happen with general practice, I think that would be a very retrograde step.’
Lord Markham responded, with regards to general practice: ‘My understanding on this is that actually it is not a massively profitable area at the moment.
‘The biggest provider in this area, Babylon Health, as we all know, did not manage to make it work. So, while I think we all understand my noble friend’s concerns, I do not believe that this is the case with the GP funding model.’
He also said that the focus for GP practices should be ‘on high-quality services and patient experiences’, regardless of practice ownership.
He added: ‘I do not believe that anyone should be fundamentally against who owns a business. What they should care most about is the supply of good-quality services.
‘I am not aware of any correlation between the type of ownership and the quality of the services from it.
‘If there is one, then we can look at that, but we are focusing resources on the areas where they make most difference, and the focus is: what is the performance of that clinic?
‘That is what we should all care about. How are the doctors there performing in terms of appointment times and everything else?
‘I will not put a false target on who owns it and the structure of it, because that is not relevant. What is relevant is the quality.’
In April, Babylon told Pulse that it had no plans to pull out of providing care to its 100,000 NHS patients in London, despite wider financial woes.
Babylon’s NHS arm GP at Hand became the first practice in England to register more than 100,000 patients on a single list in August last year.
However, its Birmingham operation was forced to close in November as part of a strategy of ‘winding down’ unprofitable NHS contracts.
Earlier this year, Pulse exclusively revealed that Babylon had indefinitely suspended out-of-area patient registrations for GP at Hand, telling prospective patients they must now live in Central Fulham.
Even with excessive use clause some private providers are not turning a profit on NHS. See their terms and conditions. Can Pulse editor check if this is correct first.
“Does my subscription cover everything?
The Babylon annual subscription enables you to book consultations with all our clinicians 24/7 all year round. It also provides access to all our in app tools including our symptom checker, Healthcheck, health monitoring tools and your clinical records.
We are here to help and want to ensure that we continue to provide the highest quality of care and service to our patients. However we may deny access to our services on a temporary or permanent basis, if we feel that your medical history is too complex for remote assessment and management, or you have excessively used our services by:
booking more appointments per year than is deemed reasonable when compared to traditional general practice (6 appointments per patient).
cancelling an unreasonable number of appointments, within 6 hours of the scheduled appointment time; or
failure to attend an unreasonable number of appointments without prior notice.”
‘General practice is ‘not a massively profitable area at the moment’, according to health minister Lord Markham.’
– what a massive understatement. It only survives because of the unpaid hard work and good will of all its staff.
‘He also cited GP service provider Babylon as one of the examples of the companies who ‘did not manage to make it work’.’
– Babylon tried to break the model in the hope that they could pick up the pieces, but it broke them.
‘‘I am not aware of any correlation between the type of ownership and the quality of the services from it.’
– actually there is good evidence that the partnership model is both the highest quality and most cost efficient way to run general practice. Ther is also evidence hospitals are very bad at it. But these inconvenient truths don’t feed NHSE’s prevailing narrative.
‘‘That is what we should all care about. How are the doctors there performing in terms of appointment times and everything else?’
– No, you should also care about the proper funding and the sustainability of the service, otherwise you will sleep walk into a disastrous collapse of the NHS.
no excrement sherlock….the lack of people willing to be partners and the loss of partner numbers is proof it that was required. If it was profitable every partner advert would have 100s of GPs ready to fill it. The sad reality is, you are lucky to get even one applicant. Who burns out and leaves within a few months of starting.
Are used to be a reasonable way to make a decent living until governments of several hues decided there was savings to be made which they took too far. One of the reasons I left my partnership in 2015 was that I had had a 5% fall in income each year in the previous five years.
Born Jovial,
Read the words – its about a “subscription” and elsewhere it talks of “compared to traditional general practice” i.e. these terms and conditions are for their purely private non NHS service. They couldn’t possibly have these as conditions for NHS registration.
Regards
Paul C
Thanks Paul Cundy for clarifying the same.
I did mention for the Editor to check if this is correct as I am not a NHS patient of the service to check it for NHS patients.
However the issue remains that the unlimited no of appointments per person for a flat fee model is not sustainable long term in private or NHS..
I have informed the editor about my original post so as to not cause confusion
Flat fee for unlimited services is ridiculous.
But so is the concept of Babylon providing NHS services pretending to be a replacement for General Practice.
“… the service may however be less appropriate” for people with learning difficulties, dementia, “complex physical, psychological, and social needs,” “complex mental health conditions,” drug dependence, or terminal illness, as well as for pregnant women and frail older people.“ GP at Hand 2016.
The idea that they kick you out if you use more than 6 consultations a year is a new one on me.
Jeremy Hunt said GPs were doing penance for the 2004 contract hence the squeeze in GP income which we all felt !
Result – the crisis is much worse and GP partners are an endangered species.
Also no adequate pandemic planning when he was Secretary of State for health !!
He is now chancellor!!
Today’s headlines: Bong- ‘General Practice isn’t profitable’;
Bong- ‘The Pope is Catholic’.
And yet they want those making more than £156k to publicly declare this for some shaming and penitence.
The evidence that by and large the remaining partnerships have outperformed every other model on quality and service is insurmountable. It is dishonest to say this is not so.
Yes, partnerships have out performed every other model on quality and service, but at great cost to the health of all who work in General Practice. 5.3% of doctors accessing the Practitioner Mental Health Services. This is a shaming statistic for the Government and Society in general.
If no one looks after the healer, they cannot heal the patients. 1 in 20 is the tip of the iceberg. Many more are suffering from the unbearable pressures of General Practice. I dodged a bullet when I cut down my GP exposure in 2018.
Wow. He’s as sharp as a scalpel isn’t he?
How pathetic that this should only just have occurred to someone in such a position. In business terms, NHS general practice is obviously a high volume low margin business model. A blind man on a galloping horse could see that. Doesn’t seem to stop the likes of Ali Parsa saying “can’t be that hard, chuck some AI at it and we can make it truly efficient and turn a nice little profit!” Wrong. Again.
And I wonder how long it’ll take this elevated entitled idiot peer to suss out that when general practice falls over, so does the whole NHS. Probably an age, to be realistic.
https://en.wikipedia.org/wiki/Nick_Markham,_Baron_Markham
Whilst there is a correlation of use of mental health services and working in GP,
this is not evidence of causation.
The cause is more likely the continued underfunding leading to being unable to
deliver to our own high standards.
The evidence of quality and efficiency would better support this.
The use of mental health services might be down to the greater insight in this group compared to others,
amongst many possible alternatives.