Patients will be allowed to register with the GP of their choice within the next year, Andy Burnham, the health secretary, announced on Thursday.
The scrapping of existing GP catchment areas would allow commuters to register with a family doctor near work, or choose another practice locally, outside the catchment area of their primary care trust.
“I want to open up real choice in primary care,” Mr Burnham said in a speech to the King’s Fund health think-tank. Patients should be able to choose a practice “based on their needs, not by lines on a map” or by postcode.
Wider choice of GP is already Conservative policy and, according to the British Medical Association, this will be the fourth attempt by Labour to widen the choice of a family doctor, with previous efforts foundering over the cost and complexity of what appears a simple change.
Dr Laurence Buckman, chairman of the BMA’s GP committee, said: “Most GPs would be comfortable with flexible boundaries.”
But “major logistical barriers would need to be overcome for a patient to be able to register with practices a long way from home”, he warned.
The issue of home visits would need to be sorted out, Dr Buckman said. But a bigger problem was that patients came with an amount of money attached to them, which funded hospital and community as well as GP services.
Big movements of young, fit patients, whose capitation fees cross-subsidise sicker and older patients, could hit funding formulas for rural and suburban hospitals and GP services, without some compensation system.
“Practices in rural and suburban areas could lose significant numbers of young, healthy patients, destabilising their funding and threatening their viability,” Dr Buckman said.
“Meanwhile city centre practices would be inundated with requests for appointments at lunchtimes and evenings, which would effectively limit patient choice.”
Dr Buckman said the problems “are not insurmountable”. But they needed “a lot of careful thought” and could prove costly to solve.
Mr Burnham appears determined to do that. Dual registration – allowing patients to register both with a practice near work and one at home – has been raised in the past, but ruled out because of the cost.
At present patients can use NHS walk-in centres for short-term problems, and can be treated as a temporary resident for up to three months.