The NHS and GPs

NHS GPs
In a way the distinction between an NHS GP and a private one is artificial, because all GPs are essentially ‘private’. This is because they are self-employed independent contractors who provide their services to the government under the terms and conditions of the NHS. Their independence is however only nominal, as those conditions control almost every aspect of an NHS GP’s work, such as the number of GPs allowed to practice in any given geographical area as well as the budgets available to them for services, premises, staff and prescribing.

These controls are all about limiting the cost of providing the public with a GP service. As with every other part of the NHS, general practice (primary care) is considerably under-funded. The difficulties of providing adequate care under the restrictions of a service that has inadequate resources are among the main sources of stress and impaired job dissatisfaction among NHS GPs and their ancillary staff.

NHS and politics
The NHS is strongly tied to the political system. Politicians know all too well that problems in the NHS reflect back to them, badly, at polling time. For decades this had led to governments chasing short-term goals that can be dressed up to look like improvements before elections. Medicine, and particularly public health, doesn’t work that way. Health improvement requires long term commitment of the type that is normal for medical and nursing staff but foreign to politicians. Because the government controls the purse strings NHS GPs have no choice but to jump through the hoops set for them even when, as has been very often the case, the targets have little or nothing to do with improving patient care in real terms.

Private General Practice
As a private GP I am self-employed in the true sense and have no-one to answer to except my patients. Freed from the controls imposed directly and indirectly by politicians I can get on with the job I was originally trained to do; a luxury largely denied to NHS GPs.

Access to NHS facilities
GPs don’t own the health service. Nor do politicians. The taxpayer pays for the NHS, and your entitlement to NHS services is therefore yours by right. There is no rule that prevents you from accessing any NHS service via a private GP as opposed to an NHS one, with one exception. Only NHS GPs can use an NHS prescription pad to prescribe medication. A private GP prescribes medicines on a ‘private’ basis, and this is more fully explained in the prescription information section. A private GP can therefore access the same facilities as an NHS GP, such as the ordering of laboratory tests, and can make referrals to specialists either through the NHS or privately.