Douglas Carswell

07 JAN 2016

Stop blaming the patients for healthcare shortages

Clacton has a chronic GP shortage. For many of my constituents, it is becoming impossible to access primary care. Analysts too often blame "demographics" for strains on healthcare. But the patients aren't the problem. Something is very wrong with our healthcare system.

Doctors in Clacton are at a premium. Three out of four of GP surgeries won't accept new patients. Even if you are lucky enough to be on the books, it is exceptionally difficult to get an appointment.

So what's the problem? The pundits would probably tell you the problem is too many patients. Clacton, they would say, has an ageing population. Doctors, they would claim, can't cope with the increasing demand on the system.

But think about this for a second: in what other area of our lives is too many clients a problem?

Does Tesco complain that it has too many customers? Does O2 worry that too many people want to buy iPhones? Does Saga claim there are now too many old people who want to buy insurance or go on cruises?

No other provider worries about too many people wanting to use it. Quite the reverse – the aim is more punters. So why is this "blame the patient" argument acceptable when we talk about healthcare?

The truth is that something is going very wrong with the system. My constituents have paid into the system all their lives. The fact that many cannot access healthcare today is a breakdown in how the system is supposed to work.

The problem is that GP contracts are centralised. A doctor with a very high workload in Clacton receives little more than a doctor with a relatively low workload somewhere else. This isn't fair on doctors. It isn't fair on patients either. The system has created perverse incentives: doctors should be incentivised to come to areas where demand is highest, like Clacton. Instead they are incentivised to leave.

The Conservative Government points the finger at Labour. They will say John Reid made things worse when he overhauled GP contracts in 2004. But what have they done, after almost 6 years, to fix the problem? Ministers fiddle with their central production targets and spreadsheets, isolated and insulated from what is happening on the ground.

The political class needs to recognise reality. We urgently need to look at how other countries deliver primary care, and see if there may be lessons for our system. Otherwise Clacton's GP shortages will soon affect the entire country.

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