Personal Blogs

I was shocked, if not surprised, to hear in the news this morning that some GPs have been removing patients from their lists for flimsy reasons and without following due process.

This is bad in itself, but I think that it’s also symptomatic of two wider problems.

The first problem is that the NHS is generally under-resourced, and this certainly appears to be true of the GP system. I don’t know if my own GP surgery is typical, but my partner has been unwell recently, and phoned our GP surgery first thing on Monday morning to try to see a doctor. There were no appointments with a doctor available all week, and the best they could manage was an appointment with a nurse on Thursday. If our surgery is anything other than a ridiculous outlier, then that is simply not acceptable. When GPs are struggling to meet the demands of more patients than they can reasonably manage, perhaps it is not surprising that they are willing to take any opportunity to remove patients from their list, and some are tempted to cut corners.

I have written and podcasted about the problems of NHS resourcing before, and I won’t go into all the arguments again here.

No, today I want to focus on another problem of which I think the latest GP story is a symptom: that our society has a serious problem with the unequal distribution of power.

There is an obviously unequal power distribution between GPs and their patients. In a caring and just society, there would be appropriate safeguards to ensure that the rights of patients are respected and that GPs do not abuse the power they have, for example, to refuse to see patients. Clearly, some GPs have abused that power. This is in breach of their contracts.

So what consequences do they face for breaching their contracts? Legal action? Losing their job? Well, as far as I can tell, the only consequence is that they get a letter from the Health Ombudsman which says something along the lines of “Dear Doctor, that was very naughty, please don’t do it again”. And that’s just the ones who get reported to the Ombudsman. No doubt there are many others who are not reported.

Now, it’s not my intention to have a go at GPs here. I’m sure that the vast majority of GPs care deeply about their patients and that the cases described here are highly unrepresentative. But I do think that what has happened here is extremely representative of the different consequences that ensue when people in a position of power misbehave compared with those who lack power.

There are many examples of this, and it worries me. For example, this week a long-running legal battle between a group of Irish travellers and Basildon Council finally came to an end. The travellers, who set up home on the site of an old scrapyard (which they own) without planning permission, will soon be evicted from their homes. Compare what happens when Tesco breach the conditions of their planning permission. No-one sends the bailiffs in to tear down an illegally built Tesco store. Why are the two situations treated differently, if not that one of the groups who breached the planning permission regulations is a marginalised minority group, and the other is a powerful corporation?

Another recent example of abuse of power was the arrest of a member of the public at a meeting of Carmarthenshire Council. She had clearly broken no laws, and was arrested simply because the chief executive of the council asked the police to do so. This was a flagrant abuse of power, for which no-one has been held accountable.

And are taxes applied equally to those of all statuses? I don’t think so. A couple of years ago, the small business that I run was a month late with an instalment of our business rates, purely as a result of an oversight. Despite paying the instalment the very same day we received a reminder from the council, and despite having no previous record of non-payment, we were still fined for late payment at the local magistrates’ court. Vodafone, on the other hand, a huge multinational corporation, seem to be able to dictate to HM Treasury how much tax they are willing to pay, and funnily enough, they don’t pay very much.

Perhaps the most flagrant example of the different treatment for people with different levels of power can be seen in two recent cases of mass law-breaking. Following the riots that took place this summer, those taking part in criminal activity were hunted down assiduously, and when caught, faced very stiff penalties.

Compare this with what happened in 2009 when it was discovered that a great many MPs had been dishonestly claiming expenses. Eventually, 4 MPs were convicted for fraud, receiving short prison sentences. But there was a good prima facie case that hundreds more had claimed dishonestly. Many of them were allowed to get away with no further action if they simply repaid the money that they had claimed dishonestly. Would those caught looting during the riots have been treated similarly leniently if they had offered to return the goods they had looted? I really can’t see any moral difference between the two. The only reason seems to be that MPs are in a position of power, and those involved in the riots lack power.