There tends to be a narrative of negativity and caution around private and online GP services.
There are those who argue these services are the catalyst for an attack on our prized NHS, a slippery slope toward privatisation and toward a two-tier healthcare system. Additionally, especially in terms of internet based services, it is a world that can be portrayed as murky or untrustworthy in some circles. Though all legitimate online and private GP services only use licensed doctors and are regulated by the Care Quality Commission.
If someone has the finances (appointments range from £30-£70) then they might well feel it’s worth the outlay for the peace of mind. Even ardent supporters of private GP services would have to accept that they are a vehicle for those with the means to pay to jump queues and get a superior service in terms of convenience - allowing people to get quick appointments that suit their schedules.
Meanwhile, often those who don’t have the cash for private services face misery trying to secure an appointment in the first place and then have to be grateful for whatever is offered potentially weeks away and requiring a rearranged diary or day off work. Though there are certainly moves to create improved flexibility even within the NHS. More and more GP surgeries now offer evening and weekend opening hours and the GP at hand scheme allows free 24/7 video appointments.
Ben Teichman, chief executive of Doctaly - an online private GP appointment service - has been quoted many times espousing the virtues of his business not just for his own clients but NHS patients too.
He told DigitalHealth: “It’s important to point out that every Doctaly patient is one less person in the NHS queue.”
Speaking to Practice Business, he also said: “We have a GP workforce that is 50% part-time and, if we can mobilise these GPs and encourage them to do additional work on much more flexible terms than the NHS allows, then we can increase appointment capacity.”
London based GP Dr Matthew Noble recently told the Telegraph, in his experience, the basic quality of care offered via private and NHS services was identical, saying: “It’s all about choice, convenience, access, and time of day. I don’t think they’ll be getting different care, but they might get a more convenient time or place.”
In that sense, perhaps it is time more people appreciated that the cost attached to private GPs pays for access and convenience - and not another tier of quality.
Can private GPs co-exist with NHS services?
Dr Diana Gall, a GP with online healthcare serviceDoctor-4-U, said: “Many people shun private GP services as being elitist and a polar opposite to the NHS, but the fact of the matter is that private healthcare and social healthcare can co-exist and complement each other fantastically.
“Private GP services offer the public a choice, and they can be used as little or as much as someone wishes. Across the country, patients are struggling to book appointments with their regular NHS doctor due to the demands placed on overstretched surgeries.
“There are times that patients choose private GP services in order to be seen sooner, which then releases some of the pressure on the NHS surgeries, and in some cases can even reduce the waiting lists for referrals.
“Working solely within the NHS can be incredibly stressful and tiring, but many doctors now split their time between the NHS and a private company, potentially helping to relieve some of the pressures that the job can bring. In a world where many people are struggling with the effects of stress, it’s important that our doctors stay healthy and keep a good work-life balance in order to give the best possible care to both private and NHS patients.
“In addition to the factors above, private services are sometimes the only option that a patient has if they’re looking for a specific treatment. Because private services aren’t funded by taxpayers or government money, they have access to more treatments and medications than the NHS. For example, many cosmetic treatments such as Finasteride for hair loss are only available privately. This means that people are still getting the treatments they need without placing more of a strain on the NHS budget.”
That said, private practice can bring its own strains for GPs. There’s a pressure to be profitable, sometimes there’s limited access to patient records and the expectations of paying patients are higher - or even that they should get what they want even if it isn’t what they clinically need. It’s also vital for GPs themselves to remember that whilst the Clinical Negligence Scheme for GPs introduced under the new NHS contract offered them a level of negligence claim indemnity, separate cover is needed for private work.
Private practice needs a charm offensive
Regardless of the arguable positives private GP services offer, there’s still some way to go to convince some people they are broadly a good thing.
GP Gavin Francis made some compelling points in his ‘Profit, not patients: the risks of private medicine’ piece for the Guardian.
In it he speaks of a private practice he experienced that got financial kickbacks from a dispensing pharmacy. He talks of cases where the NHS is left to deal with the fallout when private facilities aren’t equipped enough to complete what they started and patients with complex needs shoved back into NHS care without adequate support. In addition to cases of GPs bowing to pressure from private patients to allow procedures the patient believes to be necessary where they are not clinically advisable, sometimes with negative consequences.
He concludes: “The clinical attribute with the greatest currency of all is trust: it is essential that we continue to trust our doctors.
“If private providers with profit as their most fundamental concern are allowed to take over, trust will evaporate.”
Can private GP services benefit those who can’t afford to pay for them? It seems the answer may be that in some cases they certainly can. Though in some cases, perhaps, it may be argued they risk not being in the best interests even of those who can afford to pay.