Patients will be allowed to choose a GP

Health Secretary to let anyone register with any doctor – anywhere in Britain

Health Editor,Jeremy Laurance
Thursday 17 September 2009 00:00 BST

NHS patients are to be offered a free choice of GP, wherever in the country they choose, Andy Burnham, the Health Secretary, is to announce today.

Patients will be able to register with the practice of their choice, whether it is close to their home, their office – or because they happen to like the GP.

Under current rules, to register with one of the UK's 8,000 GP practices, patients must live within the practice boundary. These can extend for many miles in rural areas but are smaller in urban areas. They have created particular difficulties for commuters who leave home early and return late, and would prefer to see a doctor close to their place of work during the day.

Signalling his intention to press ahead with NHS reform and increasing patient choice, Mr Burnham will pledge to abolish GP practice boundaries within a year, in a speech to be delivered today at the Kings Fund, the health policy think tank.

A source said: "Patients want this, they should be allowed to have it and we are going to make it happen."

Mr Burnham will also signal that the NHS, which faces a financial storm after the current period of record growth ends in 2011, will "no longer get paid for poor treatment". NHS Trusts will increasingly be rewarded according to levels of patient satisfaction.

The British Medical Association reacted with scepticism to the proposal to abolish practice boundaries. The idea had been discussed repeatedly with ministers and officials over more than a decade but no workable solution had emerged, it said.

Laurence Buckman, chairman of the BMA GP's committee, said: "This will be the fifth time we have talked about it since 1996. It sounds superficially attractive but it is very difficult to see how it could work. We support patient choice and are happy to discuss this again but on each occasion previously it has foundered on operational issues."

Commuters would be the main beneficiaries of the change, but registering them with family doctors in town would leave unanswered who would look after them when they were sick at home or at night. Suburban practices could be left looking after the chronic sick only and could become unviable.

Dual registration, to allow patients to register with practices at home and work, had been discussed but it "costs a lot of money," Dr Buckman said.

"The danger is that you end up extending choice for some and de-stabilising it for others. This really could damage suburban practices. It is a very complicated issue not suited to political slogans."

Problems with getting access to GPs is one of the key complaints by NHS patients. A survey by Which last month of 2,400 patients found more than a third (39 per cent) – equivalent to 13 million people in the UK - said they would be interested in accessing GPs in different places - pharmacies, supermarkets, or near their work.

One in three also said they had difficulty making a convenient appointment. Almost four out of five surgeries in England now provide extended hours – at least 90 minutes a week of appointments outside the normal hours of 8.00am to 6.30pm, after the BMA lost a bruising battle with ministers 18 months ago over the increased workload.

Tory shadow Health Secretary Andrew Lansley said: "We announced plans to abolish practice boundaries two years ago. It is only a small part of the much bigger package of reform that we need to make to our system of family doctors. This is too little too late from a Labour Government which is lamely following where the Conservatives lead."

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