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Expanding GP at Hand app is a full frontal attack on general practice



Dr Kailash Chand

So the new health secretary has joined the political bandwagon to destabilise general practice.

It started when new labour adopted the Polyclinic model. Subsequent Tory administrations, with Andrew Lansley’s Health Act compounded by Jeremy Hunt’s pitching of GP against GP, has starved primary care of necessary funds and resources.

Now it is Matt Hancock’s turn, turning this steady war of attrition into a full frontal attack through Babylon’s ‘GP at hand’  app.

The crisis in general practice is unprecedented. Mr Hancock’s ‘solution’, to roll out GP at Hand across the country, could finish it off for good.

The aim of these measures can only be to grind down the current model of general practice

Babylon is happy to provide its services to anyone. Except it advises a woman who is, or may be, pregnant that it might not be suitable for their needs; nor for someone with complex mental health conditions; nor for a person with complex physical, psychological and social needs. And those with dementia or other old age conditions related to frailty or end-of-care needs are gently reminded they might need a GP closer to home.

In short, GP at Hand will readily register patients who provide the best profit margins but not necessarily those who need more resources. What this means is the funds for these healthy and worried well will boost private shareholder profits, while the traditional GP is left with dwindling funds to look after the needs of ill, old and vulnerable.

The new GP in Hand app undermines the basis on which GP practices achieve financial stability. Each time a patient registers with GP at Hand they become deregistered from their current practice, and the funding goes with them.

GP practices in London have seen their list sizes ‘shrink for the first time in years’ as a result of the app’s expansion, which is destabilising them financially. The aim of these measures can only be to grind down the current model of general practice until it fails and large private providers can be brought in to take over.

No app or algorithm will be able to do what a GP does. Patients need continuity of care and rightly expect a personalised service from their own GP rather than an appointment with an anonymised distant call centre. The GP at Hand model threatens the very survival of NHS general practice.

Dr Kailash Chand is a retired GP in Tameside