Scrap NHS Direct and patient surveys to save money, say GP leaders

BMJ 2010; 340 doi: (Published 11 June 2010) Cite this as: BMJ 2010;340:c3138
  1. Oona Mashta
  1. 1London

    GP representatives say the new government should consider scrapping NHS Direct, which costs £150m (€181m; $220m) a year, as a way of reducing costs in the health service.

    The cost effectiveness of parts of NHS Direct, which has so far not been properly evaluated, were of questionable value, said chairman of the BMA’s GPs Committee, Laurence Buckman.

    Speaking at the annual conference of local medical committees in London on 9 June, Dr Buckman listed a number of areas that “could be consigned to the dustbin” including “wasteful” private finance initiative schemes, the NHS IT programme, which is expected to cost £12.2bn, the summary care record, and external management consultants, which cost the NHS £309m in 2007-8.

    He also called for the scrapping of the GP patient survey, which last year cost the NHS £13m to run.

    “They [GP patient surveys] provide no benefit to patients because they ask the public questions they may no longer remember the answers to, and cut practice income regardless,” said Dr Buckman. “It is a GP’s job to get rid of irritants and here is a good starter list for the department to hand back to the treasury with our blessing.”

    The NHS has been told to find up to £20bn of savings by 2014 even though the health service will experience increasing demands from an ageing population.

    Hampshire GP Nigel Watson called for all 70 of the country’s walk in centres to be closed as there was little evidence that they provided value for money.

    “One recently decommissioned walk in centre estimated it cost £62 per attendance which is more than three times what a GP appointment costs, he said. “If primary care organisations decommissioned all of them there’s nearly £100m of savings.”

    Avon GP Miriam Ainsworth called for all politically driven initiatives to be abandoned to save money.

    “Quangos should be abolished and duplicate services done away with. Additionally Darzi centres, GP led health centres, Choose and Book, practice based initiatives, and a plethora of other politically driven initiatives could be scrapped,” she told the conference.

    Mark Andrews, a GP in Hertfordshire, urged the government to spell out the details of NHS cuts as soon as possible.

    “We need to be told the details, not be drip fed information. We need to be told the truth, the whole truth, and nothing but the truth. The GPC [BMA’s GPs Committee] must extract these facts as soon as possible,” he said.

    Representatives also called for the government to play a key role in reducing patient expectations of care.

    “The public need to understand that with NHS cuts there may be less provision and so expectations may have to be lowered,” said Dr Andrews. “This must come from the centre. The government must play its part otherwise patients will hear the bad news in the consulting room and I for one do not want to be delivering bad news on what is and what isn’t available. Restrictions to the range of services available must be decided nationally.”


    Cite this as: BMJ 2010;340:c3138