If I were in charge… Rule No.2
Rule 2. The ‘named GP’ should have a maximum number of patients on their list.
Pulse report on this today – in a situation of economic constriction one way of maintaining income is to keep patient lists high.
However, I haven’t added this to my list because I am concerned about greedy principals. GPs only let this slide out of desperation. We all know it is bad for care but if the money ain’t flowing, they can’t take on staff and they just have to absorb the work. It’s nasty for everyone.
The main reason for adding this is to give a measure of protection against the corporatisation of medical practices. Setting a maximum number of patients would make it harder for practices to shrink partnerships and employ nurses, salaried GPs etc while they adopt a CEO GP role and absorb the profits. It helps maintain Rule No. 1 as a reasonable prospect. The maximum number could be altered from region to region depending on factors such as deprivation, health care needs and geography. It should never be open to manipulation on pure economic grounds.
It would also protect patients against these same excesses from cold-blooded private organisations with profit motivated agendas. It might have the unintended effect of capping GP salaries but most GPs don’t want to get rich, they just want a fair salary for a fair day’s work.
However, these first two rules don’t exclude a different model for general practice. If a big company makes sure that there are named GPs active in looking after a reasonable number of patients then that’s fine as long as Rule No. 1 and Rule No. 2 are observed. So I thought we needed a Rule No. 3…
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