I agree with Cameron that GPs need to address social exclusion

Cameron accuses GPs of giving GP preferential access to ‘dinner party’ cliques

This Pulse article has, predictably, got many GPs in a right lather. I agree with Cameron that the health service needs to address access to primary care and that tackling social exclusion with progressive policies should be central to any reform.

I just completely disagree on his proposed solutions.

The abolition of practice boundaries will do nothing to improve access for the poorest people in our society. It is a policy squarely aimed at the middle classes. Abolishing practice boundaries will destabilise many practices and jeopardise universal service provision. The wholesale opening up of primary care to private services and the voluntary sector will fragment care. That will break up the system and inevitable means that those least able to navigate the system will do badly.

The deputy editor at Pulse (@stevenowottny) is right that it is an extraordinary outburst. It will infuriate many GPs and the ‘dinner party’ comments are comprehensively wide of the mark. It says rather more about how Cameron and the political classes like to do business than how GPs manage their clinical workload.

This will do nothing to engage GPs in a constructive relationship and there is already a risk that the profession spends more than enough time navel gazing. Energy spent debating whether £68 per hour is too little for commissioning work doesn’t paint a picture of a profession committed to the poorest in society. Most worryingly these ill-judged comments will distract from a fundamental issue – the need to address health inequalities through primary care and the risks of dismantling the NHS.