CALL THIS A CURE FOR NHS, SIR KEIR?
Health experts hit out at Labour plan to let patients refer themselves for treatment WITHOUT seeing GP first
DOCTORS and health experts last night rounded on Keir Starmer’s radical plans for NHS reforms.
Patients would face an even worse NHS crisis, doctors warned, after labour proposed that the public should refer themselves for medical care. One critic called the proposals ‘dangerous’.
Amid the worst winter many in the health service can remember, Sir Keir said patients should be able to self-refer themselves for specialist help, without having to see a GP.
Doctors warned that demand for care would surge and waiting lists would become even longer. The plan could see specialists ‘inundated’ by the worried well, critics said, while others warned ‘Dr Google’ – self-diagnosing on the internet – would become even more of a problem.
Sir Keir said self-referrals would cut down on ‘bureaucratic nonsense’, adding: ‘One of the proposals we’ve put forward is, would
it not be possible to consider self-referral so individuals don’t have to go to a doctor, and use up a doctor’s time, in order to get referred to specialist help?
‘If you’ve got back pain and you want to see a physio, it ought to be possible, I think, to self-refer,’ he told the BBC’s Sunday with Laura Kuenssberg.
‘If you’ve got internal bleeding and you just need a test, there ought to be a way that doesn’t involve going to see a GP.’
Tory MP Steve Brine, chairman of the Commons health committee, said Sir Keir’s comments were ‘clinically naive at best, and dangerous at worst’.
Dr David Wrigley, of the British Medical Association, said: ‘The idea that selfreferring to see non- GP specialists will help alleviate NHS pressure is very unlikely. In fact, it would probably have the opposite effect, and is precisely why we need GPs’ expert knowledge. Patients could refer themselves unnecessarily or to the wrong specialty, creating higher demand and longer waiting times for those who really need specialised care.’
Dr Philip Banfield, a consultant in Obstetrics & Gynaecology, told Sky News’ Sophy Ridge on Sunday: ‘You have people who are the worried well and the people who really have an issue say, “I don’t want to bother my doctor; I don’t want to take up someone else’s time”. So you then end up, paradoxically, with a widening health inequality.’
Waiting times, ramped up by the backlog of patients which built up during the Covid pandemic, are already a major part of the NHS crisis. The number of people in England waiting to start routine hospital treatment, such as cataract operations and hip operations, hit 7.21 million
in October, the highest number since records began in August 2007. Labour said that under their proposals, self-referrals would not be used for those with suspected cancer, or those needing to see a consultant. But they could be used for women’s health problems or for people with mental health problems, eye conditions, or those needing tests after finding blood in their stool.
Dennis Reed, from Silver Voices, which campaigns for elderly patients, said: ‘I’m not sure this proposal has been sufficiently thought through – people don’t want to do their own care and try to work out their own diagnosis – they want to see their family doctor.
‘There is a real danger people would turn to Dr Google and inundate specialists with referrals for illnesses they don’t have. Meanwhile, other people wouldn’t want to bother a specialist, so wouldn’t refer themselves and may miss out on care.’
Senior Tory MP Sir Geoffrey CliftonBrown said the ‘alarming’ policy would ‘clog up’ the health service.
‘It makes absolutely no sense whatsoever: we need our specialists to be able to concentrate on those people who are really sick and need their services.
‘Labour is wrongly using the health service as a political weapon to try and get at the Government.’
Other proposed Labour reforms include more investment, more staff and a ‘ruthless focus on ensuring patients are treated better and sooner’. Currently,
most GPs run their own practices under NHS contracts, but Labour wants to gradually wind this down.
All new GP practice managers would be direct employees of the NHS, with selfemployed family doctors disappearing altogether after existing GPs with this arrangement enter retirement.
An ally of Health Secretary Steve Barclay said: ‘Labour’s new plan for primary care is a proposal for an expensive top-down reorganisation that is uncosted and unfunded. The policy is totally incoherent.’
Dr Eilir Hughes, a GP based in north Wales, responded to Sir Keir’s suggestion that those with ‘internal bleeding’ should be able to self-refer by tweeting that this was ‘dangerous’, adding: ‘Unreasonable to expect patients to make such a diagnosis on themselves. How do you know which test they need? What do you do if their diagnosis is wrong?’
Sir Keir outlined the proposals on self-referrals and GP contracts in the Sunday Telegraph.
The Labour leader said the health service must either ‘reform or die’, that ‘wellmeaning reverence’ for the NHS had overtaken the reality, and it should not be ‘off limits’ for criticism. He added: ‘The idea the service is still “the envy of the world” is plainly wrong.’
Self-referrals were described as a way to crack down on the ‘bureaucratic nonsense’ that patients encounter every day in the health service.
Sir Keir said: ‘Every patient will have their own experience of these mundane inconveniences and inefficiencies. Across the system and across the country each one adds up, resulting in a mind-boggling waste of time, energy and money, all of which could be better spent.’
The Mail congratulates Sir Keir Starmer on finally acknowledging that the nhS must ‘reform or die’. his prescription for change, however, would make a desperate situation worse.
Most bizarre of the Labour leader’s proposals is that patients should be able to self-refer directly to specialists, bypassing their GP altogether. This would put unbearable extra pressure on already overstretched clinicians to no good effect.
his other main suggestion, to end the private GP contracts brought in by Tony Blair in 2004 and nationalise primary care, will probably have support on his party’s Left.
But even if it could be achieved, it could take decades. The service is in an existential crisis now. It needs a detailed plan for rootand-branch reform, not gimmickry. Sir Keir’s lack of any real ideas gives Mr Sunak an opportunity to seize the initiative.
If he can bring an end to the strikes without breaking the bank, drive through new labour laws to mitigate future action, accelerate recruitment and begin to cut waiting lists, he may yet win back the public’s trust. If not, he can start packing up the Downing Street flat.