Private sector a threat to primary care, say practice managers

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Private sector providers pose a serious threat to the quality of general practice and to patient care, say 68% of the UK’s practice managers in a major survey of the profession.

Many suggested that the private sector could “cherry pick” the most lucrative services, to leave the NHS funding costly, unprofitable treatments. Practice managers were also concerned that general practice may increasingly place profits before patients.

This was just one of the findings from one of the largest surveys of practice managers carried out in the UK, conducted by Management in Practice. The survey received a total of 609 responses.

Tom Brownlie, chief executive of AMSPAR, said: “The argument here is that practices are small businesses themselves. But there is a serious threat of multinationals moving into the sector, and we only have to look across the Atlantic to see where this could potentially lead.

“The situation has to be vigorously monitored to ensure a level playing field for all, with the focus on the patient and not the pound.”

The survey also revealed that nearly 40% of managers believe their surgery buildings are “not fit for purpose”, with many saying cramped conditions and lack of funding mean they are unable to comply with disabled access legislation.

Cathryn Bateman, a practice manager and consultant editor of Management in Practice, believes the results reveal more action is needed to improve GP premises for patients.

“The problem with the current system is that there simply is no funding for premises,” she said. “Primary care trust executives will be pressurised to invest in clinical services first and foremost, and only if there is anything left will money be offered to the premises pot, on which there will be a huge call.”

“We need to consider a separate pot if we are to develop the infrastructure of general practice,” she asserted.

Furthermore, nearly 65% of practice managers believed that practice-based commissioning has so far had “no effect” upon the quality of patient care.

In addition, 93% of managers said that the introduction of the new GP contract in 2004 had increased their workloads, with 45% saying their morale was worse since this contract was introduced.

Despite this, 81% of practice managers said their current morale ranged from “moderate” to “high”.

Cathryn Bateman was surprised by this positive result: “I think we are all feeling a little cheesed off at the moment with the spotlight constantly being turned in the direction of general practice,” she said.

“But the result show what a ‘tough bunch’ practice managers are. Whatever comes our way, we will get on with it, and will no doubt do a good job.”

Management in Practice Supervising Editor Stuart Gidden said: “A significant number of political measures designed to enhance local health services have been introduced to UK primary care in the last few years.

“While high-profile GP and patient surveys have been conducted in response, general practice managers – those charged with overseeing the delivery of frontline general practice initiatives – have not really been asked their views. That is why we took advantage of our large readership to canvass the opinions of practice managers on these significant developments.”
To read the full survey report, see:
Practice managers speak: the MiP survey results

For more on MiP surveys, see:
www.managementinpractice.com/surveys

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