Manager of Haxby and Wigginton Health Centre defends actions in private treatments row

11:06am Thursday 6th October 2011 in News Photograph of the Author By Mark Stead, mark.stead@thepress.co.uk

Dr David Geddes Dr David Geddes

THE manager of a York GP surgery at the centre of a privatisation storm has defended his practice’s actions.

Haxby and Wigginton Health Centre sparked national controversy after writing to about 30 patients offering them a range of minor procedures privately through a company owned by the practice, claiming NHS North Yorkshire and York had ceased funding for them.

Health chiefs yesterday denied some of the treatments were no longer available on the NHS and announced they were seeking urgent talks on the matter.

But John McEvoy, the centre’s managing partner, defended its actions. Mr McEvoy said the letter had listed other private providers as well as the practice’s own clinic. He said: “We didn’t really want to do this, but as the NHS has stopped funding for some minor procedures, we decided to fill the service gap.”

The letter listed eight treatments, but the health trust said three of these – draining fluid from cysts and treating viral warts and ingrowing toenails – were still being routinely commissioned by the NHS. It also said its exceptions panel allowed treatments that were not routinely commissioned if there was a “particular clinical need”.

NHS North Yorkshire and York’s policy was to not routinely commission procedures deemed “relatively ineffective” or “low priority”. Treatments such as cataract and varicose vein surgery where there was a close balance between benefits and risks, or where “cost-effective alternatives” may be available, were subject to clinical criteria.

Dr David Geddes, NHS North Yorkshire and York’s medical director, is now planning urgent talks with the centre, and said the trust had “significant concerns” about the letter and would have advised against sending it out if it had known about it in advance.

The trust is also understood to be unhappy about confidential patient information possibly being used for marketing purposes.

Coun Tracey Simpson-Laing, City of York Council’s cabinet member for health: said: “This is a disturbing development if a local GP practice is taking up powers planned through the Health And Social Care Bill before it becomes legislation.

“GP consortia gaining some discretion over which services it delivers free to patients and which can be charged for is the reality of the current plans.”

York Central MP Hugh Bayley said he was looking into whether Government guidance had been given to GPs about advising patients on which treatments they would have to pay for, or whether the letter was purely the centre’s decision.

The Royal College of GPs has said the distinction between NHS and private treatments was in danger of “becoming increasingly blurred”, while the British Medical Association said it was concerned about “potential conflicts of interest”.

Comments(26)

david_york says...
11:28am Thu 6 Oct 11

sounds like a bit of political posturing from labour council and labour mp and some cheeky marketing from the GP surgery!

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Son of Spacco says...
11:36am Thu 6 Oct 11

I would suggest a clear clonflict of interest in the case. Conflicting between the NHS services and FUNDING that this practice receives and the parallel private activities that they have recently added.
The greed started at this practice when they recently added a dispensing chemist on the way out, therefore depriving the chemist on the opposite side of the road the business that it used to enjoy along with a good working relationship.
When I recently visited this practice as my long standing one and receved a prescription I was verbally told to get it on the premises. I delibratley went to the other chemist out of principal!
The national press were stating that GP's were earning in excess of £100K a year already, never mind the extra wogga that can be earned from the pharmacey, how much can anyone need?

Greedy Greedy Dr's have gone down in my estimation.

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PG Haxby says...
11:46am Thu 6 Oct 11

I agree with Son of Spacco. The greed of GPs was already out of control. They manage budgets where they avoid giving adequate treatment on the NHS. When I go to that surgery am I walking into a NHS building or a private practice? It is completely against the interests of the public for it to be both.

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redrrr says...
12:08pm Thu 6 Oct 11

As someone who hasn’t seen a copy of this letter I have to ask a simple question. Did the practice state as fact that these treatments are no longer available free of charge on the NHS? If they did, then surely this is at best incompetence, i.e. they didn’t know which treatments were and were not available, or at worst fraud.

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redrrr says...
12:08pm Thu 6 Oct 11

As someone who hasn’t seen a copy of this letter I have to ask a simple question. Did the practice state as fact that these treatments are no longer available free of charge on the NHS? If they did, then surely this is at best incompetence, i.e. they didn’t know which treatments were and were not available, or at worst fraud.

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Ab Jib Jibbert says...
12:28pm Thu 6 Oct 11

As a member of another York practice, I have been advised by them that there are certain procedures which are no longer available via the NHS. The practice in question also run a "private" service that can provide the treatments, and in a brochure I got during a GP consultation over 6 months ago, it ALSO included Haxby practice and other practices close by that can provide the same services. I am happy to have the choice of provision given that the NHS is no longer funding certain procedures. What seems a little odd is that it is possible that my own GP will be performing the procedure and I will be paying for it. That said, we pay for dental and optical care, so why not also include some "non-medical" or "cosmetic" procedures too.

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rothko says...
12:38pm Thu 6 Oct 11

If this was my practice I would vote with my feet and switch to another practice.

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yorknights says...
1:04pm Thu 6 Oct 11

Excersise your choice, like the condems keep telling us, and go to another doctor. Thats what I would do if my GP was more interested in money grabbing from the sick than curing them. We have all paid for this over the years, and our parents before us. When the tories removed dental and optical treatment from us our taxes were not adjusted to take account of this change and that money given back to us was it? This is simply privatisation which ever way you dress it up - choice or no choice - and this practise is obviously more interested in putting profit before people. Walk away and get another one!

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balanced_view says...
2:18pm Thu 6 Oct 11

A very interesting quote from Hugh Bayley - who is not the MP for the area.

The Haxby MP is Julian Sturdy, whose website states about the Health Bill:

"He (Julian Sturdy) is keen to refute widespread scaremongering and assure the British public that the new measures will not result in the introduction of price competition within the NHS. Nor will they, he maintains, facilitate the cherry-picking of services."

Probably not Julian's most accurate prediction - I certainly won't be copying his lottery numbers this week.

The problem here is not that the GPs are offering these services (not all of which are 'cosmetic') at a cost to patients, it is that the rapidly diminishing PCT does not have the cash to pay for them because the government has cut the funding.

These are the same funds that the GP commissioners will have to manage when the PCT finally evaporates.

However, in addition, the Government has already said it will make further cuts ('NHS savings') to the cash available to GPs. Will the Haxby practice be alone in passing those charges onto patients - I think not.

Moreover, what new charges will need to be made by GP practices to make up the ever-widening shortfall of falling NHS funding? How long will it be before we are all charged a minimum fee per treatment as we are at the dentist?

People in York Outer constituency have a right to answers to these questions from their own MP.

After all, he is a Member of the Government's Health & Social Care Bill Committee that has put forward these changes in the first place.

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bolero says...
2:26pm Thu 6 Oct 11

I wonder whether those commenting on this issue and suggest going to another Health Centre or Doctor can tell us where we might go as an alternative please. What does seem to have been forgotten in all this is that there is such a thing as consultation. When is it intended to inform `customers`;for that is what they obviously are now rather than patients; what is going on and how does it effect them?

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Digeorge says...
2:56pm Thu 6 Oct 11

Whilst they might have jumped the gun as far as marketing is concerned, I see no difference in this than the practice or practices in the NHS York & Selby or whatever it is called area obtaining details from GPs as to patients who require retinal screening (which is a different company) and then sending letters to them to come and have retinal screening if you have diabetes!

I do wonder if Hugh Bayley MP knows his territory properly as quite rightly that is Julian Sturdy's MP area.

At least if I got a letter from the practice I would think - at last my needs are being catered for even if I had to pay.

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R'Marcus says...
3:10pm Thu 6 Oct 11

david_york wrote:
sounds like a bit of political posturing from labour council and labour mp and some cheeky marketing from the GP surgery!
It is the practice which wants to grab as much of the public's money for its self.
Pure greed.
Thank you for name and shame that practice, and all of the doctors who susbscribe to this outrageous practise.

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aUKGp1 says...
3:11pm Thu 6 Oct 11

The NHS constitution says that everyone is entitled to a comprehensive service, free at the point of need.

Comprehensive means inclusive, so this is not compatible with having "low priority procedure" lists and exceptions - the PCT is breaching the constitutional rights of citizens and then tries to blame surgeries. The PCT - as the agent of the secretary of state - is responsible for providing the comprehensive service.

Practices are not paid to waste time completing additional paperwork and red tape that only exists to turn people down (if everyone would receive the treatment they are entitled to, what would be the use of exceptions panels?)

I find it pretty disgusting that patients are forced to pay for treatment that should be available on the NHS thanks to the PCT banning it (euphemism 'not routinely funding it').

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R'Marcus says...
3:12pm Thu 6 Oct 11

balanced_view wrote:
A very interesting quote from Hugh Bayley - who is not the MP for the area.

The Haxby MP is Julian Sturdy, whose website states about the Health Bill:

"He (Julian Sturdy) is keen to refute widespread scaremongering and assure the British public that the new measures will not result in the introduction of price competition within the NHS. Nor will they, he maintains, facilitate the cherry-picking of services."

Probably not Julian's most accurate prediction - I certainly won't be copying his lottery numbers this week.

The problem here is not that the GPs are offering these services (not all of which are 'cosmetic') at a cost to patients, it is that the rapidly diminishing PCT does not have the cash to pay for them because the government has cut the funding.

These are the same funds that the GP commissioners will have to manage when the PCT finally evaporates.

However, in addition, the Government has already said it will make further cuts ('NHS savings') to the cash available to GPs. Will the Haxby practice be alone in passing those charges onto patients - I think not.

Moreover, what new charges will need to be made by GP practices to make up the ever-widening shortfall of falling NHS funding? How long will it be before we are all charged a minimum fee per treatment as we are at the dentist?

People in York Outer constituency have a right to answers to these questions from their own MP.

After all, he is a Member of the Government's Health & Social Care Bill Committee that has put forward these changes in the first place.
Well written, sir or madam.

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Theendoftheworld says...
4:42pm Thu 6 Oct 11

In the update above (that we can't comment on) The manager states that half the patients are happy to pay. If they need the procedure they haven't got much choice have they. If he'd asked the question 'would you prefer to pay or have it free on the NHS?' does he really think they would take the first option?

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redrrr says...
6:42pm Thu 6 Oct 11

Theendoftheworld wrote:
In the update above (that we can't comment on) The manager states that half the patients are happy to pay. If they need the procedure they haven't got much choice have they. If he'd asked the question 'would you prefer to pay or have it free on the NHS?' does he really think they would take the first option?
Well said. And what about those who cannot afford to pay?

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OwenC says...
8:30pm Thu 6 Oct 11

redrrr wrote:
Theendoftheworld wrote:
In the update above (that we can't comment on) The manager states that half the patients are happy to pay. If they need the procedure they haven't got much choice have they. If he'd asked the question 'would you prefer to pay or have it free on the NHS?' does he really think they would take the first option?
Well said. And what about those who cannot afford to pay?
Exactly right - if you choose the question then you can choose the answer!

We all need to wake up to the reality that this is what the NHS is going to look like - greedy politicians (and some doctors by the looks of it) are killing the NHS. We must fight to save it while there is still time or we are going to look like America in a few decades time.

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Martin Rathfelder says...
10:51pm Thu 6 Oct 11

The whole point of the NHS is supposed to be that poverty is not a disadvantage and wealth is not an advantage. If these treatments are not worth doing on the NHS they are not worth doing at all. If they are worth doing then they should be available to anyone, rich or poor.

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Digeorge says...
9:06am Fri 7 Oct 11

We already have to pay for glasses and dental treatment! I guess we are not in the same economic environment when we were years ago when the NHS was created.

Plus isn't the real problem here too what the local PCT is able to afford and willing to pay like discrimination.

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Sand piper says...
9:31am Fri 7 Oct 11

I think we should thank this group of GPs and others like them doing the same thing. The most worrying issue for me is that the PCT are not funding procedures and treatments that are available free at the point of delivery by the NHS in other parts of the country - this is a prime example of healthcare rationing by post code. These Drs have done nothing wrong they are simply providing a service to their patients and others in North Yorkshire who cannot get what they need on the NHS. They should be applauded. In addition they cannot be making large amounts of money from this activity in fact in some cases I suspect they are charging less than they would have been paid by the PCT previously. We should all look at the facts more closely here - if I was a patient of this practice I would be staying put - in my view they are a practice that clearly cares about the welfare of its patients. We should be focussing our questions at the PCT and asking what other services they plan to withdraw from the population of North Yorkshire and also exploring why they are in such a financial mess compared to other PCTs.

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tulip84 says...
11:12am Fri 7 Oct 11

Well said Sand piper, sounds like a caring practice to me. They are providing a service that is no longer available to the benefit of it's patients through the NHS and as noted, they are not the only one. I suspect the cost is a lot cheaper than elsewhere, I'm going to e mail them and ask for more details!

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Digeorge says...
12:52pm Fri 7 Oct 11

I agree - I think the Department of Health are being a little petty on the issue to be honest.

We also pay for things like osteopath, chromatic services etc.

What's the problem - it is called caring and probably won't make much money from this.

In fact, it would have probably cost more if they had sent the patients to hospital with a long waiting list!

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nmander says...
12:54pm Fri 7 Oct 11

This practice has used medical records to prepare a marketing email - this is against the data protection act. There are other issues here - which do impact on Julian Sturdey's incredibly supine acceptance of the privatisation of the NHS.

However the major point is that the practice manager should be sacked and the doctors struck off for misuse of patient data.

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Son of Spacco says...
1:29pm Fri 7 Oct 11

'nmander says...
12:54pm Fri 7 Oct 11

This practice has used medical records to prepare a marketing email - this is against the data protection act. There are other issues here - which do impact on Julian Sturdey's incredibly supine acceptance of the privatisation of the NHS.

However the major point is that the practice manager should be sacked and the doctors struck off for misuse of patient data.'

Here here, however that would entail a complaint to be made to the Data Ombusdsman at the ICO by one of the people that received the letter. I have made data protection act complaints in the past and they are pretty good at helping out.

Just for information, should anyone want to make a compliant:

http://www.ico.gov.u
k/

http://www.ico.gov.u
k/complaints/data_pr
otection.aspx

email: casework@ico.gsi.gov
.uk

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Digeorge says...
2:51pm Fri 7 Oct 11

The PCT has been doing this for years in relation to patient data sets namely for retinal screening and diabetes i.e. marketing purposes.

Sorry have to disagree with you here on this point.

At least they are offering a service which wasn't available to patients - like caring.

If you don't like the service that has been offered then simply take your patient service elsewhere!

Clearly you have had an issue with Data Protection in the past, may be its time for a change then?

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BPSP says...
12:41pm Sun 9 Oct 11

If these treatments are no longer available through Health Authority funding I don't really see a problem. It frees up funding for more important procedures. Why should someone be deprived of treatment that can prolong their life, or help them stay out of pain, just so somebody can have benign lumps and bumps drained or removed!! Grow up and stop moaning. How would you feel if you were an MS patient and you were told, 'sorry we can't afford to refill your Baclofen pump, so you won't be able to move anymore, but on a lighter note, Mrs Bloggs has had her cysts removed and her skin tags dealt with, so somebody is happy"
There isn't an unlimited supply of money, and if you don't like your GP offering this service, go elsewhere.

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