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Doctors' Lists (Removal Of Names)

Volume 929: debated on Tuesday 5 April 1977

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6.

asked the Secretary of State for Social Services whether he is satisfied with the working of paragraph 10 of the terms of service for general medical practitioners, under which a practitioner is not required to assign any reason for the removal of a patient from his list; and whether he has any evidence of anxiety caused to elderly people, in certain cases, by the operation of this paragraph.

I recognise that removal from a doctor's list may sometimes be upsetting, particularly to elderly people, but general practitioners are independent contractors who have a freedom to choose their patients, as patients have the freedom to choose their doctors.

Does my hon. Friend agree that there are at least grounds for suspicion that a minority of general practitioners rather resent having elderly people on their lists because, naturally, they take up more time and attention of the doctor than do younger people, and that such patients are removed from the list without justifiable cause?

In any case, is it not a matter of common sense and, indeed, common justice that once a doctor has accepted a patient on his list and, therefore, undertaken at public expense to provide the necessary care and attention when needed, the doctor should at least be required to give a reason if he wishes to remove that patient from his list?

If there are general practitioners who take the attitude that my hon. Friend describes, the evidence indicates that they are a small minority. If my hon. Friend has a particular allegation to make, I shall be grateful for the details so that I can look into the case.

On the question of accepting people on to a list, from time to time there are disagreements between patients and doctors, but it is not obvious that the announcement of reasons in public as to why people are removed from a list would be to the advantage of patients.

Is the Minister ready to condemn the slur on doctors by the hon. Member for Rotherham (Mr. Crowther)? Will he accept that the really important point in this matter is that there should be a foolproof arrangement for patients who have been asked to leave a doctor's list to be covered by some other doctor, and would not the arrangement between a doctor and a patient whom he did not wish to have on his list be intolerable if it were forced to continue?

I did not understand my hon. Friend to be making any slur about doctors in general. However, I do not accept that all doctors are beyond criticism. There are procedures whereby someone who is removed from a doctor's list and experiences difficulty in finding another doctor may apply to the family practitioners committee for help.