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GP practices face funding threat as online service ‘targets’ young people

Doctors and NHS staff raise the alarm as the GP at Hand model threatens the very survival of NHS general practice.

David Wrigley
25 April 2018
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Image: Person using mobile, CC0 license.

The traditional GP practice, in place since the NHS’ inception in 1948, is under serious financial threat from a new online service that is draining funding from surgeries.

Doctors in Unite (DiU) – part of Unite, the country’s largest union – are warning today that the online NHS GP at Hand service, powered by private digital health provider Babylon, is signing up predominately young people – and putting the future care of vulnerable groups at risk.

When patients register with GP at Hand, currently operating just in London, they are ‘de-registered’ from their own surgery with funding being removed from that practice.

What’s the problem? Well, losing registration fees for younger, fitter patients who join GP at Hand threatens the model of general practice relied on by so many patients, since the NHS was formed 70 years ago.

The scheme is hoovering up the younger, healthier patients and restricts access to those who are pregnant, frail, terminally ill or suffering from multiple health problems. There appears to be an element of cherry picking operating here, which, if true, is to be deplored.

In practice, 70 per cent of all patients are reasonably well. Their funding helps surgeries care for the 30 per cent who are sick. It’s a system that works, because it’s fair. We will eventually end up in the 30 per cent - and that’s why we are calling on health and social care secretary Jeremy Hunt to scrap this flawed and misguided model.

It is understood that since GP at Hand launched in London in November 2017 about 26,000 patients have registered, most of them being between the ages of 20 and 39.

Practices in the capital have seen their list sizes fall for the first time in years due to those patients registering with GP at Hand.

There is, no doubt, that GP at Hand will financially destabilise many practices robbing them of the vital risk pooling and cross subsidy which enables them to provide good care to their more complex and unwell patients.

GP at Hand targets the most profitable patients – those who are younger and healthier and don’t need extensive care from their GP.

Jeremy Hunt has said that general practice is the ‘Jewel in the Crown’ of the NHS. If he truly believes this, he will acknowledge that the GP at Hand model threatens the very survival of NHS general practice.

GP at Hand has made it clear it wishes to roll out this model of care across the country, so this scheme will threaten general practice across England.

General practice is the cornerstone of the NHS which has provided excellent care with its other community partners for decades.

NHS staff who share our concerns can sign the open letter to Jeremy Hunt here.

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Hear from:

Paolo Gerbaudo Sociologist and political theorist, director of the Centre for Digital Culture at King’s College London and author of ‘The Mask and the Flag: Populism and Global Protest’ and ‘The Digital Party: Political Organisation and Online Democracy’, and of the forthcoming ‘The Great Recoil: Politics After Populism and Pandemic’.

Chantal Mouffe Emeritus Professor of Political Theory at the University of Westminster in London. Her most recent books are ‘Agonistics. Thinking the World Politically’, ‘Podemos. In the Name of the People’ and ‘For a Left Populism’.

Spyros A. Sofos Researcher and research coordinator at the Center for Middle Eastern Studies, Lund University and author of ‘Nation and Identity in Contemporary Europe’, ‘Tormented by History’ and ‘Islam in Europe: Public Spaces and Civic Networks'.

Chair: Walid el Houri Researcher, journalist and filmmaker based between Berlin and Beirut. He is partnerships editor at openDemocracy and lead editor of its North Africa, West Asia project.

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