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Camden New Journal - by ROISIN GADELRAB
Published: 28 June 2007
 
Doctors are ordered to remove ‘ghost’ patients

GPs told to strike off healthy who rarely visit in cost-cutting move

HEALTHY patients are being struck off their doctors’ lists in a massive cost-cutting exercise imposed by the borough’s health authority.
Patients who have not visited their doctor for more than a year are falling foul of Camden Primary Care Trust’s list-cleaning, which aims to get rid of ‘ghosts’ from the books and save hundreds of thousands of pounds in the process.
But angry GPs claim the process is harming healthy patients who have not needed to see their doctor for some time as well as their most vulnerable patients.
Dr Stephen Amiel, chairman of Camden Local Medical Committee, said: “It’s unquestionably true that large numbers of patients are deducted incorrectly. Almost every week patients come in in varying states of distress having been told they are no longer our patients.
“This isn’t about reprobate GPs being caught bang to rights by having secretly non-existent patients exposed. Many GPs have made strenuous efforts to get rid of their own ‘ghosts’.
“What’s also unquestionably true is that the PCT sees list-cleaning as a major source of savings.”
Dr Amiel, of the Caversham Group Practice in Kentish Town, added: “We’re not asking to be paid for work we don’t do or patients who don’t exist.
“It’s reasonable that those patients be deducted. It’s not foolproof. Many people, particularly the elderly, people whose first language isn’t English, people living in multiple occupancy homes where mail goes missing, mental health patients – in other words, people who are the most vulnerable and disadvantaged are the ones most likely to be deducted.
“There are practices who’ve had their lists cut by 15 or 20 per cent. That’s a large amount of work in trying to check the PCT has got it right.”
The clear-out, which was trialled in three GP practices in Camden – Matthewman, Kentish Town, Bostock, Belsize Lane, and Grasse, in West Hampstead – has been extended to the rest of the borough, leaving hundreds of patients wiped off without their knowledge.
Dr Philip Matthewman said his lists had fallen from 2,350 to 1,850 through list-cleaning.
He said: “The health authority would say it’s quite wrong to pay us for patients that aren’t on our lists. How do they know? They write to every patient and if they don’t get a reply they may take it that the patient has gone away. But there might be all sorts of reasons.
“When they are removed our notes are recalled. It can take many many months to get them back.”
Dr Marek Koperski, of the James Wigg Practice, who is on the PCT board, fell victim to list-cleaning when he moved home.
Not wanting to lose his longstanding GP, he decided not to tell the health authority.
He said: “I didn’t want to move so I didn’t declare my move immediately, but the list-cleaning exercise caught me out. The issue is where someone might move a short distance in Camden and suddenly have to break a longstanding relationship.”
A spokeswoman for Camden Primary Care Trust said a letter was sent to patients in 17 different languages, adding: “List-cleaning will not affect patients’ rights to access a GP.
“If there are any incorrect deductions a patient will still be able to see their GP and can be reinstated.
“Even if the patient has moved to another address this would still be possible if they were in the catchment area.”
Camden PCT says list-cleaning ensures accurate disease registers, assists resource allocation, ensures public money is appropriately spent and helps ensure immunisation and screening programmes are effectively managed.

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