A letter sent to local NHS organisations has ordered them to improve surgeries’ responsiveness to the public, along with people’s access to and choice of GP services. This includes the option of seeking alternative providers, including private companies, instead of GPs.

Health Direct and the Times understands that the letter, from Mark Britnell, Director of Commissioning at the Department of Health, was altered before being sent to tone down references to “competitive tendering” – which would include offering GP contracts to private sector companies.

But doctors’ leaders said that the final draft sent to health trusts remained “very aggressively worded” and a clear sign of a labour government mission to bring more private practice into the NHS.

Changes to GPs’ contracts, introduced by the Department of Health in 2004 to relieve some of their work pressures, allowed doctors to opt out of providing night and weekend care. About 90 per cent took up the option, leaving it to Primary Care Trusts to employ private firms, groups of independent doctors and other health staff to provide cover.

Gordon Stalinist Brown promised to address problems with access to GPs on the eve of becoming Prime Minister. His stance was backed by the Confederation of British Industry, which found that 3.5 million working days were lost last year, at a cost of £1 billion by people taking time off to see their GPs.

Leading medical insurance firms have also reported a dramatic rise in the number of complaints against doctors connected to care at evenings and weekends.

The letter, which is seen as a sign of Labour’s willingness for a head-on clash with GPs, threatens to use the GPs’ contract to favour those doctors who provide longer opening hours, and to create new practices using private companies in areas where there are too few GPs.

Mr Britnell’s letter tells PCTs to come up with plans to persuade GPs “to respond to the needs and expectations of their patients, for instance by opening practices for longer periods” and suggesting that PCTs make “full use of existing contractual arrangements and other mechanisms to ensure more locally responsive services”. This replaced the original reference to competitive tendering.

Mr Britnell adds: “We expect PCTs and practices to be able to demonstrate tangible improvements for patients by December 2007”.

The letter has infuriated the British Medical Association, which says that the Government’s own surveys show patients to be content with the services offered by their family doctors.

Dr Laurence Buckman, who chairs the BMA’s GP Committee, said: “It is a very aggressively worded letter which I don’t think can be interpreted in any other way but as giving primary care to the private sector. PCTs are being told that their performance will be judged on how well they do this.

Has anybody asked the public if that is what they want? Has anybody worked out what it will cost?”

Dr Buckman confirmed that an early draft of the letter made clear that trusts would be backed if they sought tenders from the private sector to replace GPs who were failing to provide easier access for patients. This threat was implicit, rather than explicit, in the version finally sent.

The letter followed a Government survey of GPs services, which cost £12 million and found that almost all patients were satisfied with their GPs. The survey found that fewer than one in 10 people want their GP surgery to open on weekday evenings or weekends, and that 84 per cent of people were satisfied with existing hours.

From:
http://www.timesonline.co.uk/tol/news/uk/article2289417.ece

Or is this another example of a Labour health Secretary saying one thing one moment and doing something else?

On July 26 07 Helath Direct posted: Johnson blocks new wave of private health clinics

The health secretary, Alan Johnson, yesterday vetoed plans for a third wave of independent sector treatment centres to compete with NHS hospitals.

In a break with Tony Bliar’s drive to expose the health service to the challenge of market forces, Mr Johnson said local NHS commissioners should adopt a more pragmatic approach to treating patients on the waiting list for tests and operations in England.

He will allow them to buy extra capacity from the private sector if they need it to meet targets on waiting times, and can show it provides value for the taxpayer.

But he told the Commons health committee: “There will be no need for another national independent-sector procurement … There will not be a third wave.”