By Sarah Young
A shake-up of the GP contract system has been suggested by the director of the Adam Smith Institute, Matthew Young, in a paper due, at time of writing, to be published by April.
The recommendation follows the Government’s recent controversial plans to introduce new consultants’ contracts, which would restrict the amount of time they would have available for private practice.
Young says GPs are being held back, unlike consultants who can still make money from both public and private patients, despite the Government’s proposals which, incidentally, were rejected by the vast majority of consultants.
He adds that a lot of GPs are already overburdened with work commitments and have no time to wonder whether there is another – better – way of doing things. But, he says, they do realise there are problems with the current system and that an alternative must be sought. An extra revenue stream also has to be created where the GP can offer additional items for a charge.
“The busy executive may want to upgrade the GP service that is currently available to him,” Young says. “This arrangement doesn’t take anything from the NHS entitlements but the executive has the choice to receive something more, for a fee. This is the sort of design I believe will work if we can show how.
He says if GPs were to enter into an agreement with, for example, a supermarket, to offer premises, they could utilise a higher revenue stream from patients who are seeking to spend more on health and place more value on the GP’s services.
“At the moment, if you go to your GP and ask for an appointment you are lucky to get one at the end of the next week, and you are likely to be kept waiting for a long time in the surgery – it just becomes a complete irritation,” says Young. “If, for the sake of a small premium, or an amount paid on a yearly basis, my GP said ‘I will guarantee you an appointment when you want one’ and he will see me at that time, respond to me on demand, then I would say it is worth it.”
He says the key is choice, but at the same time guaranteeing access and standards across the board, as well as ensuring a satisfactory range of health products for everyone.
The current system is not sustainable and changes must be made, the sooner the better for everyone, he adds.
“There is already a multi-tier health system in operation but we have become trapped by the idea that health should be entirely provided by the state,” says Young. “We don’t say people have to shop at Sainsbury’s and buy all their own brand products, so why are we so belligerent about health? It is, in fact, better for the state if people opt out as it ends up saving the state an awful lot of money.”
The Adam Smith Institute is currently organising a major conference for GPs and hospital consultants to be held in early July. It will look at the benefits to the taxpayers, doctors and patients and will focus on the fact that an alternative model must be sought. It will also look at examples of health systems in other countries.