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GPs alarmed as ‘highly discriminatory’ list-cleansing targets migrants

Exclusive Patients flagged as immigrants are being explicitly targeted in PCT list-cleansing exercises, GPs have claimed.

Practices in Oxfordshire and Berkshire have raised concerns that Thames Valley Primary Care Agency, an organisation jointly funded by PCTs in Berkshire, Buckinghamshire, Milton Keynes and Oxfordshire, are using immigration flags in patient records as the basis for a ‘highly discriminatory' list-cleansing drive.

The warning comes amid reports of a surge in tough list-cleansing schemes across the country, with Pulse recently revealing that GPs in parts of London had had up to a quarter of their patient lists removed without their knowledge.

GPs fear that the measures – being accelerated as part of PCTs' push to meet QIPP savings targets – are having a disproportionately adverse affect on migrant populations.

Dr Peter Burke, a GP in Oxford, said his practice had seen hundreds of migrant patients wrongly removed from its list because of the approach being taken.

He said: ‘We've probably had several hundred immigrants taken off our list, many of whom are bona-fide UK residents but who have not responded to mailings. We only become aware of it when they consult and have to be re-registered. This means they don't get continuity of care, and the practice loses income.

‘The PCT has been upfront with us in saying they are using immigration flags in this way. This has been imposed centrally and is not just happening in our area.

‘I don't think the PCT is being malicious, but the approach is highly discriminatory.'

Dr Paul Roblin, secretary of Berkshire, Buckinghamshire and Oxon LMCs, said: ‘People not born in the UK may be fearful of official sanctions, or their language isn't great, so they won't respond to that letter and get taken off a list incorrectly.

‘So the practice finds themselves with constant reductions in the number of patients on their lists, purely because they have a high immigrant population.'

Dr Tony Grewal, medical director at Londonwide LMCs, said GPs in some parts of the capital with a high immigrant population feared their practices could go out of business because PCTs were targeting multiple-occupancy households.

‘Large numbers of immigrants have been removed because they do not have English as a first language,' he said.

An NHS Berkshire spokesperson said: ‘Thames Valley Primary Care Agency's approach to list validation on behalf of PCTs is to work with the practices to ensure only those who have moved away are removed.

‘The agency writes out to a cross-section of the population throughout the year requesting clarification of address, for example to university halls of residence.

‘Ultimately, any decision to remove a patient from a list is the decision of the GP.'

An Oxfordshire PCT spokesperson said:

'In Oxfordshire, practices remain very much in control of managing their patient lists. Throughout the year Thames Valley Primary Care Agency writes out to a cross section of the population requesting clarification of address.  Once patients have been flagged as "non-responders" their names are sent out to the relevant practices for them to have the final say as to whether they are still actively registered.

'Oxfordshire Primary Care Trust believes that those members of the public who do not respond for whatever reason should not and will not automatically be removed from patient lists without a request for input from practices themselves.'