GP surgery’s private sessions could break BMA ethics guidance

Last week the County Times featured a story about Park Surgery inviting the company Health Screen First to its Albion Way premises, to offer its patients stroke and heart screening for between £85 and £159.

This week national medical magazine for GPs Pulse contacted the paper saying the article raised ‘ethical issues’ because some of the services this company is offering are available for free on the NHS and the surgery has promoted the treatment on their own headed paper.

The surgery could be breaching guidance issued by the British Medical Association (BMA).

A BMA guidelines ethics document into ‘The Interface between NHS and Private Treatment’ states: “Although some doctors feel unhappy about their patients switching between the NHS and private sector, this is not unethical as long as the patient – when rejoining the NHS – is treated in the same way as those receiving all of their care within the NHS.

“Although it remains to be seen how the separation between the two sectors is to operate in practice where patients wish to top up their NHS care, there should always be as clear a separation as is practically possible between the two treatment sectors, in order to avoid the NHS subsidising private care and patients being charged for NHS treatment.

“Doctors should not put pressure on patients to seek private treatment or use their NHS patient lists to initiate discussion about private practice.

“At all times doctors’ primary concern should be for the safety and wellbeing of their patients.”

The letter, shown to this newspaper by a patient at Park Surgery is printed on headed paper from the surgery and signed “the doctors of the Park Surgery”. It states that it is their choice whether to take up the screening.

The letter says: “We believe that all patients are entitled to be informed about private health screening service for preventable conditions that may be of benefit where access to NHS screening is not routinely available, so that they can consider these as a private choice.”

The BMA guidelines say that GPs must not make ‘unjustifiable claims about the quality or outcome’ of private treatment, but Park Surgery has said in its letter that they ‘regard Health Screen First as the best value service’.

However, critics have told this newspaper that ‘extensive research would have to be carried out to justify this claim’.

Accompanying the letter, which had contact details of both the practice and Health Screen First, was a double-sided Health Screen First promotion leaflet.

But this may breach the BMA ethics document which says consultants should not “raise the issue of private practice obliquely, for example by handing the patient a business card containing the address of both the NHS hospital and the doctor’s private consulting rooms, or adding the private clinic address to NHS letterheads”.

Pulse magazine has interviewed Dr Brian Fisher, a GP in Lewisham, south London, who criticises the practice for promoting the private service.

He said: “This is certainly in the spirit of the current coalition Government’s policies. It’s just the sort of entrepreneurial spirit they’re looking for.

“But I can’t see what benefits patients get from it. And if they’re offering tests that are actually available free on the NHS, I think that seems rather reprehensible.”

The County Times asked NHS Sussex to confirm whether the surgery would be making any money out of renting their building to Health Screen First, and if so, how much it would be.

A spokesman said: “It is common practice for the NHS, and other public sector organisations, across the country to allow other providers to offer extra services from their premises. In this instance the money the practice is getting is going direct into their registered charity, the Friends of Park Surgery, to invest in new blood monitoring equipment for the benefit of its patients.

“The practice hope that by working with this organisation they will be able to improve the follow up care received by people who choose to take up these private health checks.

“The checks provided by Health Screen First are separate to NHS Health Checks. Free NHS Health Checks are available at the practice to all of its patients who are eligible – those aged between 40 and 74 – and this is actively promoted at the practice.”