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Flexing my independence muscles

Copperfield explains why GPs should take no notice of PCT directives to refer to private providers

Surprisingly, I don't have much objection to the idea of GPs being asked to preferentially refer patients to an under-used already-contracted private provider . But, then, that's not what's actually happening. Because GPs are being told to refer these patients to the independent sector - unless there are compelling reasons not to.

Actually, I can pretty much swallow that, too. After all, why waste money in these financially dire times if the contract's there? And I've always regarded the ‘choice agenda' as a risible, irrelevant and costly distraction – so I'm not about to start bleating when the choice patients are given is ‘take it or leave it'.

But there's something I do object to, though. And that's the idea that GPs who don't play ball might face GMC action, if those last two words aren't an oxymoron.

Apparently, it's ‘incumbent' on GPs as part of our ‘registration with the GMC' to ‘use resources efficiently'. It is? Well. Yes, it is, in fact, because I just checked on the GMC website. According to the Great and Good, we GPs should, ‘Make good use of the resources available to you.'

Oh. Hang on, though. We're also supposed to, ‘act in your patients' best interests when making referrals'. I know, because I checked that, too. Which is presumably a clinical/choice decision rather than one that bales out budgets.

Now, I don't know the rules of Ethical Top Trumps, but I reckon the ‘best interests' card would flatten the ‘resources' one any day, when you have a choice between the two. But that's not the only reason I'd cock a snook at this particular directive.

There's also the fact that, if you want to get GPs to toe the line, the worst way to do it is with an ill-advised threat. Being opinionated reactionaries/ethically informed professionals, we will simply and reflexly dig our heels in and make indignant, outraged noises.

In fact, if I worked in Heywood, Middleton or Rochdale, I would, by now, be flexing the muscles of my independence by deliberately not referring to the independent provider – unless the patient insisted, of course. What's more, I'd be shouting my view from the rooftops, or the front pages of the local rags, if they'd have me.

And I'd do it without fear - after all, the GMC seems to be improving its management of dealing with petty complaints . So let's see how it deals with this one.

Copperfield explains why GPs should take no notice of PCT directives to refer to private providers