Douglas Carswell

When GP shortages are normal, healthcare needs a rethink

There is a chronic problem with GP access in my constituency. Many of my constituents cannot get an appointment to see a GP. This problem is not unique to Clacton; it is systemic. It requires a policy rethink.

We are used to living in a world of choice. In most walks of life, service providers compete for our custom. Yet when it comes to our health, we increasingly have no choice at all. In fact, for the residents of Tendring, it is patients who have to compete to see a GP.

This problem is not confined to Tendring, because it springs from national policy. Part of the reason Tendring has a GP shortage is that GP contracts are centralised, and are paid based on the size of their patient list, not necessarily the size of their workload. GPs are often disincentivised from working in areas where demand for healthcare is higher.

The practical result for many is that they bypass the GP altogether, and go straight to A&E. This in turn puts enormous pressure on hospitals. By any metric, this is a failure.

Believe it or not, in Germany and France, people don't have to go to a GP as their first point of call. Instead they often get their primary care straight from specialists. We are chaotically sleepwalking into something similar in the UK. Perhaps we need to take lessons from Europe and think about how we could make a non-GP-based healthcare system work.

The Government is supposed to be reforming healthcare to increase patient choice. As my constituents can testify, it clearly isn't working. Britain's population is aging; our healthcare system must be flexible if it is going to cope. We need to start thinking outside the box.

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