Scrapping GP catchment areas – superficially attractive but not essentially practical

Good to hear that this isn’t a priority for the Welsh Assembly Government as the BMA can see many drawbacks to the idea of scrapping GP catchment areas.

For a start, the rest of the health service and social services and county councils all work by boundary areas, and so to just suddenly take general practice out of that system, would be terribly complicated and actually very difficult to make work.

It would be hard for patients to access a doctor in more rural areas - how would they get home visits when they are ill, if they are registered miles away, near their place of employment?

Also what would happen to practices that are destabilised because some of the younger, healthier patients have gone elsewhere? Surgeries with a mix of patients, where some don’t visit their doctor that often, help general practice to be cost-effective. If younger people register near their workplaces, some practices could be left with patient lists mainly composed of those with long-term conditions and complex illnesses, severely disadvantaging some practices.

We do support boundaries being a little more flexible, so long as practice organisation isn't interfered with. We also support practices trying to make it as easy as they can for patients to see their regular doctor whenever possible. Our main concern though is not to disadvantage the most vulnerable, which these changes could possibly lead to.

So for the Department of Health to argue that the main reason for scrapping GP surgery boundaries is to increase patient choice, is in essence a false one, with many surgeries perhaps having to close as a result of these changes. This seems to be change for the sake of it.

Posted on behalf of Dr David Bailey, Chair of GPC Wales.

WAG puts the development of GP practice premises on hold

I am extremely concerned that the National Assembly Government has put a stop to the development of GP practice premises across Wales, whilst the NHS reorganisation takes place.

Recently, they gave an instruction to Local Heath Boards to immediately stop planning for projects in primary care in Wales. This means that patients who have to visit their doctor in unsuitable surgeries across the length and breadth of Wales, will have to wait years before they see an improvement in building standards. It also means that many doctors will have to work in premises they know are inadequate and not fit for purpose.

Chairman of the BMA's GP Committee, Dr David Bailey has given this reaction: "Despite claiming that one of the Government's stated aims is to move care out as much as appropriate into the community closer to patients’ homes, there is now significant planning blight on primary care premises development. To me, this seems, to say, the least illogical.

"GPC Wales is fully supportive of the drive to move care closer to patients homes and utilise the skills and expertise that exist in primary care. However decisions such as this – ostensibly to allow planning by new organisations not expected to exist until 2009 – seem to demonstrate a worrying lack of joined up thinking and will have an effect on morale in primary care, probably much greater than the actual delay in premises development."

"We would urge the Government to reconsider the issue of this advice and allow LHBs to continue to develop primary care estate and the capacity of NHS Wales right up to the moment they cease to be accountable for these important responsibilities.

It is totally unacceptable that both patients and GPs will have to put up with inadequate premises whilst the NHS reorganises itself - a process which will take at least a year to bed down."