Overworked GPs refuse to accept new patients

Thousands of GPs are refusing to accept new patients because they cannot cope with the number they already have, doctors' leaders said yesterday.

The British Medical Association said a serious shortage of family doctors had forced many GPs' practices to close their lists. One doctor said the problem was so severe that overstretched GPs were in danger of being sued for negligence because they were unable to provide adequate care.

Dr Chris Lancelot, a GP in Lancashire, said: "It is inevitable that a case of negligence will eventually be brought against a GP in circumstances like these.

"With too little time for each patient, an overworked, over- allocated GP will be forced into risking making mistakes through taking shortcuts or from being overtired."

Doctors usually have lists of about 1,500 to 2,000 patients, but some GPs are having to care for as many as 3,500 people, which is the maximum number permissible under long-standing regulations. Although doctors can close their lists when they have fewer than 3,500 patients, primary care trusts can force doctors to reopen their lists if there is no space at other practices in the area.

Dr Lancelot said the maximum amounted to a "potentially dangerous" number of patients and he called for "a drastic downward revision" in the threshold, which was double the size that many GPs regarded as safe to manage.

Dr Hamish Meldrum, the joint deputy chairman of the BMA's General Practitioners Committee, said the problem stemmed from the growing difficulty in recruiting and retaining GPs.

"It is quite a serious problem and it is something we have been warning the Government and previous governments about for some time," he said. "The most common reason is when one doctor retires and then a practice cannot recruit another one.

"They are left with a higher list of patients to look after and find the only thing they can do is to take no new patients."

Dr Meldrum said his own three-doctor practice in East Yorkshire had been forced to close its lists temporarily when it was missing two full-time GPs and there was a delay in recruiting replacements.

He said an accurate assessment of the problem was difficult, but it was "certainly into the high hundreds of practices – which is thousands of doctors – whose lists are closed or who are reluctant to take on new patients".

Dr Meldrum said the system of allocating patients needed to be overhauled. In the long term, he hoped that a new contract, currently under negotiation, would make general practice a more attractive career option.

In the short term, measures such as increasing pay, persuading GPs not to retire early or enabling more doctors to work part-time might help.

A survey published yesterday showed that most GPs believed patients should be charged for failing to turn up for appointments. Nearly 60 per cent of doctors said they would support charging patients, according to research for the Doctor Patient Partnership.

It also showed that two-thirds of GPs believed people aged between 16 and 34 contributed most to the problem of 15.5 million missed appointments each year.

John Hutton, a Health minister, said: "We all have a responsibility to ensure we use health resources fairly ... Missed appointments are wasteful and disruptive."