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Boundaries will be axed – eventually

By Gareth Iacobucci

The coalition Government has confirmed its intention to abolish practice boundaries as part of its plans to extend patient choice – although Conservative sources insist their party does not see it as a priority.

The coalition agreement between the Tories and Liberal Democrats includes a pledge to ensure ‘every patient has the right to choose to register with the GP they want, without being restricted by where they live'.

Department of Health officials said they would continue with the previous Government's consultation on plans to get rid of practice boundaries, although it would now be extended by a month and is due to close on 2 July.

But although both parties have backed reform to the current boundaries system to expand patient choice, the wording of the coalition pledge is lifted from the Lib Dem manifesto, and some Conservative sources suggested the Tories might not push hard to get the measure through.

Dr Jonathan Steel, a GP in Uley, Gloucestershire, and member of the Tories' health policy advisory committee, said: ‘I don't think [boundaries] will be particularly high up the pecking order.

‘My instinct is Andrew wants to have a good relationship with the profession, so will not want to go out of his way to introduce something inherently abhorrent to general practice.'

Dr Paul Charlson, chair of the Conservative Medical Society and fellow advisory committee member, agreed, suggesting handing GPs real budgets, reforming out-of-hours and tackling NHS inefficiency were much higher priorities: ‘We don't want to destroy good-quality general practice for the sake of dogma. If it can't be made to work within the cost envelope, it might be a casualty.'

LMCs across the country have tabled vehement opposition to the plans in a series of motions to be debated at the upcoming LMCs conference.

One motion says the policy will be costly to the taxpayer ‘at a time when the country can least afford it' and ‘add risk to the GP home-visiting service'.

The previous government's preferred option, thought to also be favoured by the Tories, would allow patients to register anywhere, but with only those living close to practices qualifying for GP home visits.

Dr Paul Charlson