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GP choice can solve access problems

Alison Payne in The Scotsman

‘Postcode lottery’ is a phrase often used in the media referring to different levels of service people receive depending on where they live. It is a phrase that is often misused, but Reform Scotland believes our latest report, “Patients First: Improving Access to GP Practices”, demonstrates there is a genuine postcode lottery in Scotland in accessing GP services.

Depending on where you live, the way in which you can access GP services can be quite different. Whether your practice is open in the evening or at weekends, whether it allows you to book appointments or order repeat prescriptions online, or indeed whether it even has a website, can be determined purely by where you live. And crucially, it’s a lottery because patients have very little choice over the GP practice with which they can register.

Diversity is a good thing, and something which there needs to be more of in all public services. However, for diversity to help raise standards across the board, people have to be able to choose between providers, in this case GP practices.

Reform Scotland believes the problem could be readily resolved by increasing the choice of GP practice available to patients by enlarging the catchment areas of GP practices and allowing new practices to open up. Many people would probably still prefer to join the practice closest to them but, by enabling patients to move and go elsewhere if they are unhappy with the way they access services where they are; there is greater pressure on all GP practices to improve.

Our research has shown the information explaining how to access GP services provided to patients and prospective patients to be patchy, inconsistent and of variable quality. At the very least, why can’t we require all GP practices to publish full details about their services on a website?

The top five negatively-rated issues in the Scottish Government’s GP survey were all related to how patients accessed services. Reform Scotland believes the recommendations we have set out in our report are a step in the right direction and would help improve that experience for patients.