Andy Burnham has a MA in English. Andy is also the Secretary of State for Health in HM Government. Before Andy became responsible for the health of the nation, Andy was
“Secretary of State for Culture, Media and Sport (January 2008 to June 2009); Chief Secretary to the Treasury (June 2007 to January 2008); Minister of State for Delivery and Reform at the Department of Health (2006 to June 2007); Parliamentary Under Secretary of State for Immigration, Citizenship and Nationality at the Home Office (2005-06) and Parliamentary Private Secretary to Ruth Kelly, Transport Secretary (2004) and David Blunkett, Home Secretary (2003-04)”.
With other words, Andy is as much an expert on general practice as I am an expert on etymology. He nevertheless presides over an impressive flock of civil servants, political advisors, private secretaries, etc (for further reference, please watch ‘Yes Minister’). One day Andy (btw, that’s what he calls himself on his homepage, so who am I to call him anything else) must have woken up and thought: how about increasing competition between general practitioner’s surgeries. Why let geographic boundaries decide which doctor the voter has to see? Let competition flourish and the best practice win.
Lovely idea, innit?
If only Andy and his minions would have thought this through. While I won’t even mention the problems practices in sleeper towns would have (if all the patients of working age suddenly register next to their workplace), the biggest problem is continuity of care for home visits. At present, GP’s visit their own patients at home if they are frail or illness renders them immobile. But what would happen if a patient living in North London, registered with a GP in South London next to his work place, fall ill? Does Andy really believe that the South London doctor will spend 3 hours on the tube to get to his patient? So the poor chap in North London has to have access to some sort of care up in North London. Currently he is not allowed to register with two practices, and even if, continuity of care would be a complete disaster, with one practice not informed about the other practice’s current referrals and investigations. At present the out of hour cooperatives are not responsible for patients during working hours, so should they expand their services? With what doctors? The ones that are already tied up in the government’s attempt to expand evening and weekend access?
There used to be a time when voting Labour was the natural state of affairs for healthcare workers.
This has changed.