Intended for healthcare professionals

Views And Reviews Acute Perspective

David Oliver: Private GPs—a manufactured media scandal?

BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4167 (Published 09 October 2018) Cite this as: BMJ 2018;363:k4167
  1. David Oliver, consultant in geriatrics and acute general medicine
  1. Berkshire
  1. davidoliver372{at}googlemail.com

During a weekend working on the acute medical unit I noticed a visitor reading a copy of the Mail on Sunday. A prominent headline caught my eye: “Can’t get in to see your doctor? Highly paid GPs accused of driving up waiting times by favouring lucrative private clients over NHS patients.” At home that evening I looked up the piece on the Mail’s website.1

Three bold bullet points lay below the headline: “Many doctors work part time for the NHS, taking time out to see private patients”; “One in 30 GP consultations is privately paid for, netting doctors £550m a year”; and “A pressure group said it was ‘pretty obvious’ NHS patients would wait longer.”

What substance lay behind all of this? The article was based on a LaingBuisson consultancy report of 2013-14 healthcare market data2 (“the latest available figures,” the Mail article says). So why has the Mail dusted it down now, as if it were news? It warns us, “The number today could be higher still.” Pure scaremongering: in fact, LaingBuisson produces an annual report, and the last didn’t show a big rise in private primary care.34

The Mail quoted the BMA and the Royal College of General Practitioners in highlighting unmanageable workloads and a workforce crisis in general practice, as well as warning of the effects of longer waits for appointments and unmanageable consultation numbers.56 But it ignored the context and intent of the RCGP’s comments—which were certainly not designed as some kind of smokescreen for GPs moonlighting in the private sector.

The “pressure group” referred to above was Patient Concern—a frequent source of comment for Mail group articles, tending to confirm editorial lines. Patient Concern7 is a small organisation, admirably and openly free of commercial conflicts of interest, but it’s one, uncorroborated perspective.

Why has the Daily Mail dusted down the report now, as if it were news?

The Mail piece threw in a reference to the average pay of full time GP partners. But it neglected to mention that many GPs are salaried or less than full time, earning far less,89 and that doctors’ real terms pay has steadily fallen for several years (all found in an easily searchable BMA media briefing).10 The article pointed to GPs’ supposedly high pay levels “when satisfaction with them has hit a record low.” But has it?

Well, the 2018 British Social Attitudes survey did show increasing concern and falling satisfaction over access and waiting times in general practice—but it also put doctors and nurses at the top of the public trust league, while demonstrating continued support for the NHS and its staff and a recognition among respondents that workforce and funding shortages were key concerns.11 The latest GP patient survey showed that 83.8% of patients described their overall experience of their GP service as good, and 95.6% had confidence and trust in the healthcare professional they saw.1213

The report contained a small amount of investigative journalism, amounting to one group practice in Hertfordshire and one in central London, where one partner they phoned at each offered faster private appointments than in their NHS practice (although, in the latter case, outside contracted hours). It hardly amounts to an exposé telling us anything useful about the wider picture—but it would certainly make readers angry.

There’s an interesting story to be written about the demand for more responsive, fee paying, concierge-style access to general practice, bypassing the NHS. The Mail’s story isn’t it.

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