24 Hour Urgent Care

Lansley's obsession with "choice" seems likely to be pushing primary care towards a more expensive system. The new policy is that anyone will be able to register with any GP practice regardless of where the patient or the practice is. There have even been suggestions that this will be beneficial to the dimwitted homeopathy fanatics who will seek out and register with a sympathetic GP; since there are few such GPs and the dimwits are spread over the country, this will result in a lot of distilled water being posted across the country. (My tip: buy a bottle from Halfords.)

Of course there are serious reasons behind this choice. If you commute a long distance and have a long term condition then it may make more sense to register with a GP near your work so that you only need to take an hour or so off work to see your GP rather than the entire afternoon (remember: Lansley has told GPs that they no longer need to have extended hours, so you are unlikely to be able to get an appointment in the evening or ion a Saturday).

The problem is that what happens if you are ill when you are at home? The government suggests setting up a separate 24 hour urgent care system integrated with the out of hours service.

The Government stated: ‘If you choose a GP practice further from where you live, it is important you also have access to urgent medical care near home. We propose to develop a 24/7 urgent care service in every area of England, incorporating GP out-of-hours and in-hours urgent care where necessary for people who aren’t registered with a local GP.’

But the BMA says that this policy "risked a potentially dangerous fragmentation of care, and could prove unaffordable at a time of biting cuts" More interestingly are these comments from Paul Conroy:

There are two hidden agendas here that GPs need to be alive to: 1) GPs will have to commission out of hours and therefore, they will also have to commission the 'in hours urgent care' as well. This will hit our pockets, not the central purse. 2) The long term objective is to re-shape primary care to a provider approach, where family practice disappears completely, in favour of big corporations who dispense care like a medical supermarket.