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Ever decreasing primary care circles

In many countries, getting to see a GP is no easy feat. In a British Social Attitudes survey in 2020, around 51% of people agreed that “it was hard to get an appointment with a GP”.

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Most people in the UK are familiar with ringing a GP surgery at 8 am on the dot, trying dozens of times and finally reaching a receptionist an hour later – only to be told that all appointments are gone and you should have called at 8am! Is it any wonder more and more patients are turning to private healthcare? Polling performed by YouGov on behalf of the Times found that 7% of those polled had consulted private GP services in the past two years, and 3% were new users.

Patients want to see doctors quicker, at a more convenient time to them, get referred if necessary and arguably have the opportunity to see a better doctor too – or a least a doctor of their choosing. Being restricted to whatever GP is local cuts patient choice, and with private-pay, patients have more say in their primary care physician, often relying on the internet or word of mouth as their guide. But what about GPs? How big is the appeal to leave an NHS-funded practice and move to a private-pay one?

According to Pulse magazine, substantial – around 48% of GP’s they surveyed would consider working for an online private GP service, and of that percentage around 1,200 GP’s already do. Critically, 38% said that they would, but part-time. The ability to work part-time and/or remotely could enable and encourage those that wouldn’t traditionally go into, or return, to a full-time NHS practice situation; this could include caregivers, retirees, those with mobility issues, or just those that would prefer to work from home.  Although it’s not all about working from home of course, many private GP’s are providing in-person services too, but crucially patients have time slots of up to 30 mins. That thirty-minute slot not only provides the patient ample time, but it means the GP isn’t under pressure just to move on to the next patient all the time.

There is a similar shift ongoing in dentistry. According to the UK British Dental Association, 3,000 dentists have stopped doing NHS work since the beginning of the pandemic.

Primary care is often under-resourced and overstretched. Private pay with higher rates, flexible working and longer time slots, offers to alleviate some of that pressure for the GP. But is it an ever decreasing circle of benefit? The more pressure government puts on a dwindling GP workforce, the more will jump ship to private-pay practice, leaving the NHS provision even further under-resourced and patient dissatisfaction will grow. Pushing the government to apply more pressure and the cycle continues.  The flip-side to this is that the NHS primary provision is virtually unsustainable and dissatisfaction levels as they are mean that 48% of GP’s could be gravitating toward private-pay. This doesn’t bode well for the future of NHS primary care – and leaves the door open for increasing private-pay primary care provision.

We would welcome your thoughts on this story. Email your views to Kirsty Withams or call 0207 183 3779.