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GP practice website problems would be solved by going private, claims Scottish think tank

A Scottish think tank has recommended that GP contracts be opened up to private companies to improve patient choice after finding only two thirds of the country’s practices have their own website.

Reform Scotland – an independent public policy organisation that claims to have no links to any political party – said that opening more surgeries in Scotland would widen patient choice, thereby putting ‘greater pressure on all GP practices to improve’.

Reform Scotland’s director, Geoff Mawdsley, said that giving individuals greater choice over their GP practice would mean that people ‘were able to easily walk away’ from GP practices if they felt their services did not suit them.

He added: ‘We don’t envisage that such a policy would lead to a mass exodus of patients from GP practices, but the potential that they could would give them much greater influence over the way services developed.’

Reform Scotland’s report, Examining Access: Survey of GP practices in Scotland, highlighted discrepancies in ease of access between GP practices across Scotland and drew particular attention to ‘frustrating’ issues with online access.

The think tank’s survey of Scotland’s 994 GP practices revealed that only 67% had their own website, while only 51% allowed patients to order repeat prescriptions online or by email. Only one in 10 operated online appointment booking systems, despite the recommendations made on this subject in 2010 by the RCGP and Scottish Government.

The survey also found that the small number of Scottish practices that were entirely funded by NHS health boards (42 in total) had even worse online access – only 29% had their own website, and none had online booking services.

Reform Scotland made several recommendations as the result of the survey, including the provision of more and clearer information to patients about GP services, improving online access and information, and giving patient ‘greater choice’ over their GP practice.

The report said: ‘There has been much discussion in the referendum campaign about protecting the NHS in Scotland from privatisation, even though most people in Scotland’s contact with the NHS is through a private contractor – their GP. Basically, they [GPs] are private monopolies within our NHS.’

The report’s authors described the GP partner model as ‘illogical’ and called for a ‘more consistent approach’. They said: ‘Either you believe that private companies should not be providing GP care, in which case all GPs should become salaried GPs and be employed by the NHS, or you believe that the private sector can provide GP care.’

But Dr Andrew Buist, deputy chair of the Scottish GPC, told Pulse that while the report had identified room for improvement, opening up the market to private companies was ‘not an appropriate solution’.

He said: ‘The system now is not perfect and we recognise there are problems with access. But public limited companies come with shareholders who drive how the business operates. In the current GP partnership model, the partners are actually the clinicians providing the care.

‘The models are not the same at all – yes, GP partners are independent contractors, but we’re absolutely steeped in the values of the NHS and that is our primary consideration. We don’t need to respond to shareholders and our independent status gives us flexibility to respond to constant changes in practice.

‘Reform Scotland say they’re not aligned to a political party, but they’re certainly aligned to a political ideology – that of opening up the market, which isn’t good for patients in the long term, particularly those in deprived areas.’