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Leave general practices alone and focus attention on the NHS's big holes

Last week, I met up with two young GPs who are taking over an existing practice.

Unusually, these two GPs are taking the practice from an existing private provider that can't make it work. The danger of course is that these GPs will also be unable to make it work. Certainly the existing company is making significant annual losses, but a more detailed review shows that the contracts are well funded. The problems at the moment are twofold.

Firstly, if an outside provider takes on a contract, they have to pay their GPs to see the patients before they can get any return. Secondly, for any business to run well, (and I am including general practice within the definition of a business) it has to be managed. A GP practice owned and managed remotely is never going to be as profitable as one where the GP owners are on site. I think these two GPs will be able to make something of this practice.

This morning I heard on the radio about the problems of the South London NHS Trust. Losses of £1,000,000 per week due (it says) to the onerous PFI obligations. That may be true, but some people were running this trust and incurring these losses.

Also this week, there was an announcement that reimbursements for GPs that are not obligatory but at the PCTs' discretion (such as locum reimbursement for sickness or maternity) will no longer be paid.

I think this suggests a misguided thought process. General practice is profitable because it is efficient. It is efficient because the partners who work in it and own it, don't get paid if they run it inefficiently. It seems to me that the attention needs to be directed at the big holes in the NHS, leave general practice alone, it works quite nicely thank you.

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