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Solo GPs face more GMC hearings Solo GPs face more GMC hearings
(about 23 hours later)
Figures obtained from the General Medical Council raise more questions over the future of GPs who work alone.Figures obtained from the General Medical Council raise more questions over the future of GPs who work alone.
They reveal that GPs who work on their own are six times more likely to be summoned to a disciplinary hearing than GPs working in group practices.They reveal that GPs who work on their own are six times more likely to be summoned to a disciplinary hearing than GPs working in group practices.
This comes amid bitter rowing between the government and the British Medical Association (BMA) over surgery sizes.This comes amid bitter rowing between the government and the British Medical Association (BMA) over surgery sizes.
A year ago former health minister Lord Darzi launched a plan for a network of polyclinics, one-stop health centres.A year ago former health minister Lord Darzi launched a plan for a network of polyclinics, one-stop health centres.
Lord Darzi's plan envisaged numbers of doctors working with other health professionals in brand new facilities which could handle minor injuries, childbirth, dental and psychiatric care.Lord Darzi's plan envisaged numbers of doctors working with other health professionals in brand new facilities which could handle minor injuries, childbirth, dental and psychiatric care.
The BMA has fought tooth and nail against the proposals, voicing concerns that they will be too big to offer patients continuity of care, and that they will not provide value for money.The BMA has fought tooth and nail against the proposals, voicing concerns that they will be too big to offer patients continuity of care, and that they will not provide value for money.
'Fitness to practice' hearings'Fitness to practice' hearings
The GMC figures, which Newsnight has obtained, show that 17 so-called "single-handed" GPs and 67 GPs working in group practices came up in front of a "fitness to practice" hearing in the last year.The GMC figures, which Newsnight has obtained, show that 17 so-called "single-handed" GPs and 67 GPs working in group practices came up in front of a "fitness to practice" hearing in the last year.
I have been a single-handed GP and I know how tough it is to deal with some of the acute crises that can occur if you don't have a colleague to refer to immediately. Michel Coleman, London School of Hygiene and Tropical MedicineI have been a single-handed GP and I know how tough it is to deal with some of the acute crises that can occur if you don't have a colleague to refer to immediately. Michel Coleman, London School of Hygiene and Tropical Medicine
According to the National Health Service in England, Scotland and Wales there were 38,728 GPs in multiple practice and 1,589 "loners" for the relevant period.According to the National Health Service in England, Scotland and Wales there were 38,728 GPs in multiple practice and 1,589 "loners" for the relevant period.
This means that there was roughly a one in 100 chance each year of a single-handed practitioner coming up in front of the GMC, and a one in 600 chance of a GP in a multiple practice doing so.This means that there was roughly a one in 100 chance each year of a single-handed practitioner coming up in front of the GMC, and a one in 600 chance of a GP in a multiple practice doing so.
In other words singles were six times as likely to be in front of the GMC.In other words singles were six times as likely to be in front of the GMC.
Newsnight asked medical statistician Michel Coleman from the London School of Hygiene and Tropical Medicine whether these numbers represent a statistically significant finding.Newsnight asked medical statistician Michel Coleman from the London School of Hygiene and Tropical Medicine whether these numbers represent a statistically significant finding.
He said that "a six-fold difference in these numbers is unlikely to happen by chance, but don't conclude that single-handed GPs must be worse doctors simply on the basis of that comparison".He said that "a six-fold difference in these numbers is unlikely to happen by chance, but don't conclude that single-handed GPs must be worse doctors simply on the basis of that comparison".
Mr Coleman said it might be some unconscious bias in the GMC process and that lone GPs are at a disadvantage because they cannot consult with colleagues: Dr Coleman said it might be some unconscious bias in the GMC process and that lone GPs are at a disadvantage because they cannot consult with colleagues:
"I have been a single-handed GP and I know how tough it is to deal with some of the acute crises that can occur if you don't have a colleague to refer to immediately.""I have been a single-handed GP and I know how tough it is to deal with some of the acute crises that can occur if you don't have a colleague to refer to immediately."
Shipman legacyShipman legacy
Ever since Harold Shipman took advantage of his solo status to murder hundreds of his patients, health authorities have been trying to push GPs into multiple practices.Ever since Harold Shipman took advantage of his solo status to murder hundreds of his patients, health authorities have been trying to push GPs into multiple practices.
They have been early casualties of the government's drive under Lord Darzi to centralise and update GP services.They have been early casualties of the government's drive under Lord Darzi to centralise and update GP services.
Ruth Carnall, head of NHS London, said last year:Ruth Carnall, head of NHS London, said last year:
"We're not forcing GPs to leave. But can single-handed practices provide the range of modern primary care and other services? The answer is 'No.'"We're not forcing GPs to leave. But can single-handed practices provide the range of modern primary care and other services? The answer is 'No.'
"What isn't possible is the single-handed GP operating out of his front room. The ones which are going to close are the ones in crappy end-of-terrace houses where you can't park, get up the stairs or get a pram through the front door.""What isn't possible is the single-handed GP operating out of his front room. The ones which are going to close are the ones in crappy end-of-terrace houses where you can't park, get up the stairs or get a pram through the front door."
Newsnight talked to one London health boss, who wanted to remain anonymous, who told us he is trying to "squeeze out " GPs who work on their own.Newsnight talked to one London health boss, who wanted to remain anonymous, who told us he is trying to "squeeze out " GPs who work on their own.
He thinks they are not up to date with current medical knowledge, reluctant to seek help or advice, and often work in unsuitable premises.He thinks they are not up to date with current medical knowledge, reluctant to seek help or advice, and often work in unsuitable premises.
He said he even considers financial inducements, such as pay instead of notice, to persuade such doctors to quit general practice.He said he even considers financial inducements, such as pay instead of notice, to persuade such doctors to quit general practice.
Watch Susan Watts' full report on Newsnight on Wednesday 22 July at 10.30pm on BBC Two.Watch Susan Watts' full report on Newsnight on Wednesday 22 July at 10.30pm on BBC Two.