Doctor!  An NHS Uber GP Service?

Doctor! An NHS Uber GP Service?


Article kindly provided by John Furse.

A new app offers 24/7 medical advice ‘in the palm of your hand…so you can talk to a GP when it suits you and your family, wherever you are in the world.’. The Babylon app allows patients to skip queues to see a GP, by allowing them to pay for medical care seven days a week. Supporters argue that the app, which has been described as working like a ‘taxi booking service’, will take pressure off busy GP surgeries and A&E departments. Doctaly is another new online  ‘booking service’ who similarly arrange same-day appointments with NHS GPs charging for this private provision of their services. Babylon and Doctaly are part of a wave of hi-tech, DIY medical care initiatives being pushed by NHS England.

But according to the National Health Action Party (NHA) the devil is in the detail of the exclusion clauses contained in the agreements patients sign up to with these whizzo private GP providers. “Once embarked on a private route everything that follows, tests and treatment, is private too. Lots of people seem to see it as NHS queue jumping to see the GP. Not so. It’s the gateway to private healthcare,” says the NHA. Doctaly charges people between £39 and £49 for a 15-minute GP appointment during office hours and the cost rises to £69 for appointments out of hours, such as before 9am and after 6pm. Doctaly does not employ its GPs directly but takes a cut of their fee for their Doctaly “pay to see GP” appointments. Patients then pay for subsequent treatments they receive.

Patients choosing and booking an appointment through Doctaly’s website are asked to confirm they aren’t registered at the GP practice they choose. The BMA General Practitioners’ Committee’s deputy chair Richard Vautrey says that “the risk is a more fragmented service and patients having remote consultations with doctors they don’t know and who won’t have full access to their NHS medical records.” It also prises patients away from their underfunded, overstretched GPs and into the hands of private competitors, rather than providing the proper public funding their GPs need for their NHS services. 650 GP surgeries have already been closed, merged or taken over since 2010 and the Royal College of General Practitioners warns that up to a further 600 surgeries face closure by 2020.

NHA’s Dr Louise Irvine is concerned that some GPs may be “tempted to fill the holes in their funding, which is at an all-time low right now, by taking on this (Doctaly) additional work. Dr Jackie Applebee, chair of Tower Hamlets Local Medical Committee, says that the Doctaly scheme could “further destabilise general practice…This sort of service is the slippery slope towards privatisation of the NHS. It introduces the principle of topping up NHS services with purchased services if one has the disposable income. If the more affluent begin to do this in significant numbers, it is only a small step to an insurance-based health service.”

That’s because, by attracting more and more of the public to privately provided services and to private health insurance schemes to cover their costs, this will undermine the argument for universal taxation to fund the NHS’ provision of universal, quality healthcare for all regardless of income, a founding NHS principle. As in the US we’ll develop a 2-tier healthcare system; a more expensive, accessible private one for the better off and a cheaper, less accessible public one for the worse off, leading many to put their homes at risk to pay for their healthcare. Private healthcare is now the biggest cause of personal bankruptcy in the US. “Don’t Get Sick In America!’ will become ‘Don’t Get Sick In England!’.

In 1977 Thatcher pin-up Nicholas Ridley declared to the Conservatives’ Economic Reconstruction Group “Denationalisation should not be attempted by frontal attack, but by a policy of preparation for return to the private sector by stealth. We should fragment the industries as far as possible; and set up the units as separate profit centres.” The deliberate underfunding of the NHS and GP services, by 2020 the cuts will amount to £40 billion, along with their ‘reconfiguring’ using private ‘booking services’ like the Babylon app and Doctaly, is central to the breaking up of what was once the cheapest and most cost-effective public healthcare system in the developed world. NHS England’s current Sustainability & Transformation Plans (STPs) for ‘reconfiguring’ a broken NHS are intended to put it back together again with the private sector pervasively embedded within it. This is the climax of over 30 years of Ridley’s envisaged NHS privatisation by stealth under both Tory and Labour administrations.

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