'GPs denying care to those who complain': Survey shows that doctors are striking off patients regarded as 'troublesome'

THOUSANDS of patients including the chronically sick, the old and the mentally ill are being removed from doctors' lists, often without explanation, according to the patients' watchdog, the community health councils.

The survey, published today, says those most likely to be struck off the lists are often patients who have complained.

The report comes only four days after William Reid, the health services ombudsman, launched a fierce attack on the way the National Health Service handles complaints in his annual report. The National Association of Community Health Councils of England and Wales says that in the last year more than three-quarters of the CHCs have dealt with cases of patients being removed from lists. In Manchester, 1,700 people are known to have been removed against their wishes.

It is common that when one patient goes the whole family is removed. Toby Harris, director of the association, said yesterday: 'It is hugely unfair the way some GPs treat their patients. You can even get struck off for being too ill. What is more, once you have been struck off it is difficult to persuade other doctors to take you on. You get labelled as a troublemaker.'

The report says it is difficult to obtain accurate information on how many people are removed against their will, as 92 per cent of CHCs do not regularly receive this information from the local family health service authorities, which administer the GP services and are charged with helping patients to register with doctors if assigning GPs is necessary.

Half of the patients known to the CHCs had problems finding another doctor. One family was finally allocated a doctor eight miles away. The report says that excluded patients fell into specific groups. 'These included people with mental illness, so-called 'difficult' patients, and elderly people. One CHC reported: 'Some GPs' perception of patients who have been removed from lists is that they must be troublemakers'.'

A spokesman for the National Association of Health Authorities and Trusts, which represents family health service authorities, says that patients should not be struck off on grounds of expense or risk. It had no evidence of this happening in fund-holding general practices. 'Patients can sometimes be struck off because they are disruptive or abrasive to others.'

Philip Hunt, director of the association, said that sometimes the doctor-patient relationship broke down irretrievably, but 'usually it is the patient who withdraws first'. Dr Ian Bogle, chairman of the British Medical Association's GPs committee, said: 'In the vast majority of cases patients are only removed from a GP's list when the doctor-patient relationship has broken down. Many GPs do give patients reasons why they are removed, despite having no obligation to do so.'

Leading article, page 17

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