Health Bill amendment proposes mandating GPs to work in deprived areas

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An amendment to the new Health and Social Care Bill, which is currently at committee stage in the House of Lords, proposes that GPs be mandated to work in deprived areas.

The amendment, proposed by Lord Hunt of Kings Heath, proposes the creation of the ‘General Medical Practitioners Equitable Distribution Board’, which would have ‘discretionary powers’ to prevent GPs from taking jobs in areas where there are already a sufficient number of doctors.

Lord Hunt said the council would be a reiteration of the Medical Practices Committee for England and Wales (MPC), which had been in place from 1948, until it was abolished with the Medical Practices Act 2001. health and social care.

Speaking in the House of Lords last week, he said: ‘I envisage the council being vested with discretionary powers of negative direction, just like the MPC.

“This would review applications from primary care networks, and they would only be expected from NCPs who were falsified enough, or more than falsified enough.

“It would be a way of intervening in the market and making it more difficult to appoint general practitioners in areas that are already very well supplied with doctors.”

It comes as in November last year the Department of Health and Social Care said it ‘did not acknowledge’ media reports that it was considering commissioning GPs to work in areas disadvantaged.

But Lord Hunt, who currently sits on the GMC board and is a former health minister, urged Health Minister Lord Bethell to ‘take this back’ to get the government ‘to pay attention’.

He said it was “an approach that has worked in the past”, adding that “frankly, I don’t think we can go on without major intervention to try and spread the load”.

‘[I]Clearly, the odds are against you if you are in an area of ​​high poverty where there are far more patients per GP. You burn out among the professions and things get very difficult indeed,” he said.

The Social Market Foundation think tank had also proposed the Office for Equitable Distribution of GPs in England in a report published in November.

However, BMA GP committee vice-chairman Dr Kieran Sharrock told Pulse that “simply banning family doctors from taking on roles in certain areas is not the answer” to solving the problems. issues of health inequities.

He said: ‘The bottom line is that we have a significant national shortage of GPs, and a tactic of ‘stepping into the market’ and telling existing doctors where they can and cannot work will not solve any way. permanent recruitment crisis in general medicine.

“To incentivize the recruitment of GPs in under-doctored areas, the government needs to focus on addressing the significant resource allocation issues in GP.

“As Lord Hunt rightly points out, working in an area of ​​high poverty comes with its own set of unique challenges, and yet, ironically, these GP practices are generally the least well resourced.”

The government “needs to realize that a one-size-fits-all approach to GP funding is not the answer”, added Dr Sharrock, saying “what is needed is the political will to tailor health care according to the needs of local populations”.

“Until the government fixes this, doctors will continue to be attracted to work in low-deprivation areas where their hard work is better recognized and rewarded,” he added.

“We need more GPs and support those working in the most difficult areas with appropriate resources so that these places can both deliver for patients and become more attractive places to work for staff.”

Lord Hunt also proposed an amendment that would ‘ensure primary care professions have mandated roles within integrated care partnerships’, which was backed by the BMA.

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