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The NHS: a dysfunctional family?

GPs are part of the NHS Family, which bring to mind images of contented parents and children sitting in a warm room by the open fire listening to the Queens Christmas message. But what happens when it goes wrong?

Dr GY came to see me this week, in a state of frustration. Back in 2006 Dr GY had a notification suggesting he had been overpaid by his PCT, but no explanation offered.

On his behalf, we wrote to the finance officer at his PCT and asked for clarification, and for four years, despite our reminders getting firmer and firmer we never received a reply. Late last year, still without any explanation or warning they deducted the overpayment – a significant amount. Our requests for an explanation continued to be ignored. We wrote to the director of finance (no reply) and then to the chief executive (no reply). Total family breakdown.

Cue supernanny. With limited options left, we asked the local MP to get involved, which proved effective. She insisted the PCT have a meeting with Dr GY and ourselves. Supernanny gets her way, the meeting is held, but promises made to pass on detailed information are not fulfilled.

So this week, Dr GY reveals the PCT have made another unexplained clawback to his finances, and wants to know where he goes from here.

Take a step back here. This is a good GP offering a good service to his patients but he is being treated with contempt by the PCT.

So to answer his question, where do we go from here? One of the implications of being part of the NHS family is that one member cannot sue another. Instead, difficulties have to be referred to the NHS Litigation Authority (see www.nhsla.com/FHSAU/ for more information). I suppose the equivalent of Family Therapy up in Harrogate.

The problem is that Dr GY believes that if he takes this further and upsets the PCT more, they will be more difficult and punitive and so has backed off taking this further.

He is going to reluctantly put up with the PCT's actions. It’s a shame, and actually in this case, the PCT should be ashamed.

There was a time when PCTs and their officers worked with GPs, sitting effectively at the same side of the family table, but there are more and more examples of broken promises and adversarial relationships. That time has gone.

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