Doctors 'conspire to stop patients switching GPs'

GPs were today accused of operating "gentlemen's agreements" in which they refuse to accept other doctors' patients.

Health minister Ben Bradshaw risked fresh conflict between the Government and doctors with his claim that some GPs stop patients moving to other practices.

By doing so, surgeries can keep people on their own patient list and preserve their funding.

Mr Bradshaw's attack came as he announced plans to overhaul the GP system, including moves to allow the public to receive medical advice online.

He also revealed that there was one practice in the South that had only two patients on its books.

The minister refused to say exactly where the practice was, but it underlined how some doctors' surgeries are allowed to survive purely because patients were prevented from moving to other GPs. The Government has previously focused on increasing patients' choices over which hospital they want to use.

But ministers are now determined to extend similar freedoms to family doctor services.

"There is no doubt there are some areas where gentlemen's agreements operate that mitigate against lists being open to new patients and therefore work against real patient choice," Mr Bradshaw told the BBC News website,

Doctors' leaders said his comments were "absolute nonsense", and his remarks threatened to open up a new rift between family doctors and the Government.

Mr Bradshaw, an unabashed reformer, has already clashed with doctors in recent months over extending opening hours and plans for polyclinics.

At present, GPs are paid a lump sum plus money for each patient on their list. To reward doctors who take on new patients, the lump sum - worth a total of £580 million - will be cut and the per-patient fee increased.

Mr Bradshaw said the lump sum "dampened the incentive" to attract new people to surgeries and meant some doctors were able to survive with very few patients.

Lawrence Buckman, chairman of the British Medical Association's GP committee, said: "It is absolute nonsense to suggest there are gentlemen's agreements - it just doesn't happen. Nor are we going to compete for patients, that is not the way general practice works."

Dr John Canning, of the BMA's Professional-Fees Committee, blamed the Government's changes to funding in 2004 for the lack of incentives to take on new patients.

Today's Primary and Community Care blueprint also aims to modernise services and let people use a computer to keep in touch with their doctor.

A secure 'myhealthspace' website will allow people to access and update their record, book appointments and order repeat prescriptions.

The plans, which are aimed at complementing Lord Darzi's NHS hospital reforms unveiled this week, will also allow some patients with longterm conditions to control their own treatment funding.

GPs will also be rewarded for the prevention as well as cure of ailments. For example, extra funds will go to those who prescribe exercise.

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