Page last updated at 09:29 GMT, Thursday, 17 September 2009 10:29 UK

Plan to scrap GP catchment areas

By Nick Triggle
Health reporter, BBC News

Andy Burnham: "I want the best to be available to everyone, not according to where they live"

Health Secretary Andy Burnham has announced plans to scrap GP catchment areas in England within a year.

Ministers want to introduce more choice into the family doctor system, believing it will drive up standards.

The move has been on the cards for some time and is part of the government's long-running drive to improve access.

Doctors' leaders said they were not opposed to the idea, but warned there were some issues that still needed resolving.

The government has been seeking to get more from GPs ever since their pay rocketed with the introduction of a new contract in 2004.

They have already got many GPs to open for longer, but the idea of ending catchment areas was being talked about by ministers even before Gordon Brown became prime minister.

It was also mentioned by Lord Darzi when he unveiled his review of the health service last summer.

Boundaries ending

In a speech in London, the health secretary said ending the boundary system will help "drive up standards" and that he wants it introduced by next autumn.

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Patient choice is a well established right in hospital care with people entitled to choose from any hospital in the country for treatment.

Mr Burnham said: "I want the best to be available to everyone, not according to where they live.

"Too often people's choice of GP practice is unnecessarily limited by practice boundaries, so, with the profession, I want to open up real choice in primary care."

Mr Burnham said people's choice of a GP should be based on their own needs - not by lines on a map.

He said plans would be put in place to ensure vital services, such as home visits, would be protected.

"In this day and age I can see no reason why patients should not be able to choose the GP practice they want.

"Many of us lead hectic lives and health services should be there to make things easier."

He cited examples where commuters may want to register with a GP near their work or a mother close to her children's school.

GPs agree their catchment areas with local health managers.

They vary in size with some rural doctors seeing patients up to 40 miles away, while city-based doctors often refuse people who are outside a two-mile radius.

Doctors' warning

Formal discussions are still to take place with the British Medical Association, the doctors' trade union.

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Aren't we suppose to be saving money? This sounds like more NHS bureaucracy
Ian Baildon, Bradford

Dr Laurence Buckman, chairman of the BMA's GPs committee, said the union was willing to work with government on how the idea might be implemented.

But he said: "The rest of the health service and social services and county councils all work by areas, and suddenly we're going to take general practice out of that and that is very difficult to see how you can make it work.

"We think it is going to be very complicated."

He added: "It is going to be very difficult for the patients who are able to get a doctor remotely - for example, how will they get home visits? - and for the patients who are left behind.

"What will happen to their practice if they're destabilised, because some of the younger, healthier patients have gone elsewhere?"

The union says that a mix of patients, some of them not visiting their doctor often, helps general practice to be cost-effective.

It warns that if younger people register near their workplaces, some practices could be left with patient lists mainly composed of those with long-term conditions and complex illness.

Roger Goss, of the campaign group Patient Concern, said introducing competition might help to improve the overall quality of primary services.

"The less successful surgeries will have to work harder to provide a quality service. It's a good thing if the really incompetent surgery goes out of business."

Shadow health secretary Andrew Lansley said: "We've always argued that it was ludicrous for the government to talk about giving people a choice of GP when they restricted that choice based on their postcode.

"This is too little too late."

There are no plans to alter catchment area regulations in the rest of the UK, where they tend to be much bigger, and there is less pressure on GPs' lists.

Mr Burnham is also expected to set out details of how he plans to link hospital funding to patient experience.

Again, this was a policy which was set out in the Darzi review, but is now being promoted as a key plank in the next stage of improving the NHS.



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