More Del boys will become GPs

The following story from Martin Beckford, The Telegraph's health correspondent, based on a survey of GPs by the BMA illustrates an important, and often overlooked, aspect of reforms.  Changes to incentives and processes not only change the way people behave (often the intended consequence) but also the type of person that opts for those positions (the unintended consequence).  So it will not only make GPs behave more like Del boys, more Del boys will become GPs.

The survey's headline finding is that 1 in 7/8 GPs responding to the Survey intend to retire in the next two years.  So the reforms are driving out a large number of GPs.

One question to jump out is whether that is really a startling statistic.  Assuming that every GP has a 36 year working life, and that GPs have an even distribution in terms of age, then one would expect 1 in 18 to retire in the next two years.  However both the term "next two years" and "intention to retire" are sufficiently vague for many with a general intention to wind down over the next few years to answer "yes."  In addition, self-selection may also be an issue: the survey findings are based on 10,000 responses from a population of nearly 50,000.  Lastly, one needs to consider whether individuals' responses were aligned to strengthen the political point they and the BMA may wish to make - and whether the responses were designed to sandbag in that way.

Ignoring those issues and taking this statistic at face value, this finding illustrates the secondary consequences of reforms - which are often overlooked.  A group of people will be driven away from primary care by this change, and a group of people will be attracted to it.  These two groups of people will be very different, and over the years the character of GPs as a whole will change from the former to the latter - more conversant with financial flows, more commercial, and - dare one say it - more at home in a competitive market.

The question this raises for the reforms is: who do you want running your GP practice in 20 years time?  Trotters Independent Trading Co. New York - Paris - [Insert name of your town]