We (Doctors for the NHS) have grave reservations about the ‘Doctaly’ service as reported in Pulse last week – a private GP company NHS GPs to patients who are prepared to pay a fee to avoid waiting.
Doctaly does not provide emergency treatment. It recommends you go to A&E for that. They also do not help with psychiatric complaints or chronic disease. They advise that you see your regular GP. This looks suspiciously like the reality of much private practice which cherry picks the easiest elements of care and leaves the rest to the public sector.
As a profession general practice is under immense stress with vacancies in many practices. Every GP does their surgeries, home visits, out of hours work and trains the next generation of doctors. It is a full workload.
Because of the funding shortage, which all elements of the NHS are facing at the moment, some GPs might be tempted to fill the holes in their funding by taking on this additional work.
Some people might view this as ‘privatisation by the back door’ but it is looking increasingly like the government is holding the front door open for it. The funding constraints may become too great and our fellow practitioners may be forced to adopt this way of working. Our greatest worry is that we are being forced regardless into a two-tier system, whether our profession wants it or not.
Unlimited access to a GP and all their services for under £140 per patient per year is fantastic value. We want to work with more GPs to help develop a better funded, more co-ordinated service and provide a positive alternative to the dismantling of services we now see. We ask our colleagues to join us here.
Dr David Wrigley – GP, Carnforth, Lancashire
Dr Paul Hobday – Vice Chair, DFNHS; GP, Sutton Valence, Kent
Dr Peter Fisher – President, DFNHS; Consultant physician (retired)
Dr Eric Watts – Chair, DFNHS; Consultant haematologist, Brentwood, Essex
Dr Peter Trewby – Treasurer, DFNHS; Consultant physician, President of the Association of North of England Physicians
Dr Jacky Davis – Consultant radiologist, Whittington Hospital
Dr Colin Hutchinson – Consultant ophthalmologist (retired)
Dr Jonathan Dare – Retired child and adolescent psychiatrist, Kings College and Maudsley Hospitals
Dr Pam Zinkin – Consultant paediatrician, London
Dr Malila Noone – Medical microbiologist (retired)
Dr Cathy White – Consultant paediatric neurologist, Swansea
Dr Morris Bernadt – Consultant psychiatrist, London
Doctors for the NHS
Dr Dinesh Silva, GP and co-founder of Doctaly said: ’Doctaly was created to connect patients and GPs and aims to provide an additional and accessible service to support NHS practices and patients. As a full-time GP, I was keen to find a solution that compliments my NHS practice and doesn’t work against it. Our trials have shown that both patients and GPs have welcomed the new service and we have had patients who have told us that if they hadn’t seen a GP via Doctaly then they would have gone to A&E.
’In relation to the suggestion of ‘cherry-picking’, this is simply not the case. We suggest that any patient with serious symptoms such as chest pain, severe pain, shortness of breathe go to A&E, in the same way that any GP practice would signpost potentially serious symptoms appropriately. It would be irresponsible and unsafe to suggest otherwise. We also advise against presenting with chronic disease problems and psychiatric problems as the most effective clinical management will be dependent on having a complete clinical history, which as of yet the GP will not have. We strongly believe that this is in the interest of patient safety and effective clinical decision making.’