In response to the letter from Dr Williams (5 September) about Reform Scotland’s report on access to GPs, our research showed that there were certainly areas of Edinburgh where patients fell into the catchment area of only one GP practice.
Not every patient will have the expert knowledge of Dr Williams and, for them, the process of finding out which catchment areas they fall into is a complicated and time-consuming one.
Indeed, in order to clarify things we had to put in Freedom of Information requests to the Scottish Government and all 14 health boards in Scotland.
While some health boards provided maps, NHS Lothian provided a list of descriptive areas, which was in itself far from clear. Therefore, to make his assertions, Dr Williams must have information that is not widely available to the public, even when they do seek it directly from the health board.
Catchment information should be far clearer and more readily available to patients.
Our primary solution to this problem was to give patients wider choice by extending the catchment areas of GP practices.
We don’t think this is impractical, as most patients will still wish to choose a practice close to their home and GP practices currently manage to deal with plenty of patients who are out of their catchment areas.
However, if combined with much greater information about the access arrangements offered by different practices, such as extended hours or open surgeries, patients would be able to choose a practice that meets their particular needs.
As an organisation, Reform Scotland is largely funded by voluntary donations from individuals ranging, in the last financial year, from £10 to £25,000.
As is clearly set out on our website along with their names, less than 10 per cent of our funding comes from our four corporate partners.
People support us because they support the aim of the organisation, which is to put forward policy ideas, based on research findings, to stimulate debate on how we might improve public services and the performance of the economy.
We are entirely independent of any political party or any other organisation, and we do not accept donations with any strings attached, nor do we do commissioned research. Therefore, to suggest there is any conflict of interest is an allegation completely without foundation.
Our view is that public services should be responsive to their users. Following the publication of our report, the number of people appearing on news programmes or radio shows who were not happy with the access arrangements at GP practices suggests that far from inventing these problems, they are ones experienced by many patients.
If the BMA and Dr Williams won’t listen to us, maybe they will listen to patients.
North St David Street
The Reform Scotland report on GP access raises some interesting points. There are good reasons why GP practices have catchment areas. Other health care professionals such as health visitors, midwives and mental health teams, are usually attached to a general practice, but are zoned geographically. This suggestion would mean GPs dealing with teams in different parts of the city, so eroding team working and communication. This is vitally important in areas such as child protection matters.
As a working GP, I can see about five patients per hour in the surgery. Visits take much longer and would take even longer if visiting across the city. Not a good use of GP time.
Access to extended-hours surgeries is patchy. Perhaps this is because these surgeries are as well as – not instead of – the normal GP working day.
This might explain why not all GPs are willing to work these extra hours. If GPs are to maintain a reasonable work-life balance some reduction in normal daytime working would be needed. Perhaps patients could suggest which part of the 8am-to-6pm day they would like to see reduced.
Finally, I agree that all practices should have websites and provide an online repeat prescription service. My practice has been doing this for years and it is not rocket science.
(Dr) Gordon Scott
Tollcross Health Centre
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