Cap on number of GP visits being considered by Tories

Idea on website 'breaches National Health Service principle of treatment based on clinical need'

A cap on the number of times patients can visit their GP in a year is being considered by the Conservative Party, it emerged yesterday.

A Tory consultation document on local health provision asks activists whether they agree or disagree with the idea of an annual limit on GP appointments. The paper also asks whether evening and weekend appointments with GPs and consultants are a "luxury the country cannot afford".

The proposals, which the document admits are "controversial", were yesterday condemned for targeting the most vulnerable, who need to see their doctor more often than others. They also fuelled the debate raging over access to GPs, out-of-hours services, and the pressure on accident and emergency departments. Dr Clare Gerada, chair of the Royal College of GPs, said the idea was "short-sighted".

Labour seized on the document, describing the proposed limit as a threat to the core National Health Service principle of access based on clinical need. The revelation follows the appointment earlier this month of Nick Seddon as Downing Street health policy adviser. Formerly of the think-tank Reform, he has suggested NHS cuts and charges for GP visits.

The document is buried on the website of the Conservative Policy Forum, chaired by Oliver Letwin and supported by the Tory co-chairman Grant Shapps. The forum brings together activists from constituency groups to discuss ideas for the next two years of the coalition, the 2015 manifesto, and future Tory government policy.

On the conservativepolicyforum.com site, the "discussion brief" document, entitled "Local Health", is dated last month and was sent out from the central party, although no author is identified. It asks for views from activists on the future of the NHS, based on the four priorities of the Health Secretary, Jeremy Hunt, of improving the standard of care throughout the service, bringing the "technology revolution" to the NHS, improving treatment and care of dementia and other long-term conditions, and improving mortality rates for the big killer diseases.

Conservative party members are asked to agree or disagree with a list of sentences, including "There should be no annual limit to the number of appointments patients can book to see their GP". It also lists "GPs should take greater responsibility for out-of-hours care in their area", "Families should be responsible for the care of their infirm relatives" and "Open competition within the NHS is undesirable". Members are also asked whether NHS money should be moved from areas with the greatest need.

Labour health spokesman Jamie Reed said: "This paper, hidden away on their website, reveals the Tories' true agenda for the NHS. After throwing the NHS open to ever more privatisation with a wasteful and damaging reorganisation, it seems the Tories want to go even further.

"It's shocking that they are considering limiting the number of times patients can see their GP – changing the fundamental principle in the NHS constitution that access to the NHS is based on clinical need.

"The Tories have already wasted £3bn on a top-down reorganisation of the NHS and overseen a crisis in A&E – now they are consulting their members on opening up the NHS to even more competition, and making it harder for patients to see GPs in the evenings and at weekends."

Dr Gerada said: "This was obviously written by someone who has never been unwell, or has never met people who work in the health service." She said she would typically see an elderly patient 10 to 15 times a year, and patients with depression three to four times a month. Describing the idea of an annual limit as "very short-sighted", she added: "People come because they are ill or because we are asking them to come because we are concerned about them. What we should do is fund general practice sufficiently so that we can offer flexible appointment times."

Mr Shapps has described the Conservative Policy Forum as a "direct line from our members to Oliver Letwin MP, the minister for government policy". He has said that the forum "affords our members a unique opportunity to contribute towards the writing of the next Conservative Party Manifesto". A Conservative Party spokesman said: "This was simply a topic to provoke discussion and isn't party policy."

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