SUGGESTIONS that family doctors working within the NHS should be allowed to refer patients to their private practices have been criticised by an NHS GP – who also runs his own private practice in Tunbridge Wells.
Dr Coonjobeeharry, 53, known by his patients as ‘Dr Harry’, has been a partner at the NHS-funded Old School Surgery in Cranbrook since 2003.
But in October 2013, he established his own private clinic, GP Consulting in Frant Road, Tunbridge Wells. He splits his week, working three days in Cranbrook and two with his private patients.
And it is this separation which Dr Harry considers fundamental to ethical practice, and why he is so concerned by recent developments from his fellow practitioners.
Plans are being discussed by local medical committees (LMCs) around the country to allow doctors to refer patients to their own private clinics.
Recently, an NHS GP surgery in Bournemouth set up a private service where patients can pay up to £145 to skip waiting lists to see a doctor.
The service will be operated by the same NHS doctors from 8am until 8pm Monday to Friday and 8am until 12noon Saturdays.
It offers same-day, ‘unhurried’ and ‘personal’ care ‘rather than the rushed NHS clinics that the cash-strapped service is encouraging’.
Under the terms set out in their contracts, family doctors are not allowed to offer private services to their own NHS patients as this would create a conflict of interest. They are allowed to do private work, but only for patients registered at another practice.
Dr Harry has 1,600 NHS patients on his books and agrees that it ‘frees up the NHS’.
He said: “If you want your ear syringed, for example, and you don’t want to wait weeks for it, if you have the money, some people will elect to pay.”
But he thinks allowing doctors to refer their own NHS patients to their private practice is ‘crossing the line’.
“As of now, the ethos of GPs who also work privately was: ‘If it’s available on the NHS then you can’t offer it privately’. Because otherwise there is a conflict of interest.
“How can you trust a GP if they have a stake in you going private?” he asked.
As an alternative, he champions his own model of distinct patient lists.
“I only see patients who are not my NHS patients. I keep it completely separate so it is not compromising. You have to be open about who you are and what hat you are wearing, your private or your NHS one.
“Don’t be on call at the same time because you could start to prioritise your private patients because it is more rewarding to you. That’s morally wrong,” he asserted.
There is growing concern, particularly in affluent areas such as Tunbridge Wells, that more and more experienced doctors will choose to go fully private, leading to a brain drain from the NHS.
“The exodus has already begun, and it’s accelerating slowly. Lots of GPs in their 50s are going a lot earlier than they would have done.
“A lot of them are just firefighting at the moment, and they are completely demoralised. The workload is just not sustainable and wages have dropped year on year,” he said, citing about a 30 per cent pay cut over the last ten years.
These changes have meant the next generation of doctors don’t want to take on a partnership role because they can earn the same money on locum or salaried contracts.
They will just offer consulting sessions, rather than being tied to a particular dedicated practice.
Dr Harry suggested that since partners take more responsibility in the management of the practice, this could make things ‘a lot worse’ for surgeries.
“For every two GPs that retire, you’d need to hire three salaried or locum doctors to do the same amount of work,” he said.