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Scrapping practice boundaries has the private sector rubbing its hands

By Richard Hoey

The DH proposals to get rid of practice boundaries create a free-for-all, and big business has lined itself up to take advantage

Sometimes, all the news comes at once.

Occasionally, that is a coincidence, but very often it is not.

Take this week – Virgin is re-entering primary care, Care UK has re-financed itself through a takeover and at just the same time, the Department of Health has revealed its initial proposals for scrapping practice boundaries.

I may be sticking my neck out out here, but this feels one of those non-coincidence occasions.

Practice boundaries have often been cited as a barrier to true competition by just these sorts of company. Indeed, Care UK's Dr Mark Hunt forcibly put the case for getting rid of boundaries in a debate piece for Pulse last year.

With boundaries gone, the gloves will be off.

And judging by the actions of Virgin and Care UK's new investors, private companies seem to think there will now be sufficient incentive to attract new patients to make general practice a commercially attractive place for them to be.

The key question, though, is: what kind of patients will these major private companies wish to attract?

A clue may lie in an advisory document submitted to Virgin Healthcare during its first, and brief, voyage into primary care waters.

A report prepared back in 2006 by market research firm Goodstuff advised Virgin to target young male professionals, suggesting: ‘From a business point of view, this audience are the most lucrative to recruit.'

‘They help fulfil a quota without putting a great strain on resources,' it added.

Virgin protested at the time that the advice was never acted upon.

But Goodstuff were quite right of course. Under the current financing of primary care, it is more lucrative to target young affluent patients, whereas it isn't lucrative at all to attract the old, the infirm, the chronically ill, those from poor backgrounds.

This Government has insisted, very loudly, that it intends to address the entrenched inequalities in the UK's healthcare.

The mismatch between its words and its actions is perhaps today's real story.

By Richard Hoey, Pulse editor