Volume 1

The regulation of private and other independent healthcare : fifth report / Health Committee.

  • Great Britain. Parliament. House of Commons. Health Committee
Date:
1999
Catalogue details

Licence: Open Government Licence

Credit: The regulation of private and other independent healthcare : fifth report / Health Committee. Source: Wellcome Collection.

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    arrangements for children.'** We recommend that the independent health regulator ensures that inspection teams have appropriately trained and experienced personnel to assess thoroughly the needs of children being treated in the independent sector and to ensure that such needs are met by staff holding the relevant qualifications for treating children even if their treatment forms only a small proportion of a hospital’s activity. WALK-IN MEDICAL CENTRES 83. One of the fastest growing areas of unregulated independent medical activity is the walk-in medical centre. Sinclair Montrose opened its first walk-in medical centre (Medicentre) at Victoria Station in August 1996.'” There are currently 12 Medicentres, four attached to London mainline railway stations and eight attached to shopping stores or in shopping centres.'*” The rapid growth of Medicentres suggests that they are responding to a market need. In this regard it is interesting to note that the Government have taken a similar initiative in drawing up proposals to open 20 walk-in centres to provide “a new option for people who need flexible and fast access to primary care services because of the hours they work or where they live’.'*! 84. We visited the Medicentre at Victoria Station. We were told that the centre was popular with commuters, local residents and tourists and that increasingly people were nominating the Medicentre as their sole GP. Nevertheless the majority of people visiting Medicentres were also registered with a GP elsewhere. 85. It is this issue of dual registration which most concerns us. The BMA told us that the development of walk-in GP clinics caused them “considerable concern”.'” They felt that the essential prerequisite was prompt communication with the patient’s NHS General Practitioner “so that the lifetime medical record is properly comprehensive, and to enable the provision of safe care”.'*? The Department had similar misgivings, noting that “these services are not designed to provide continuity of healthcare”. They felt it was not “generally advisable for patients to have advice from two GPs except in cases where information is shared’.'* 86. The potential gap in communication between the walk-in clinic and NHS GP seems to us critical. Sinclair Montrose told us that new customers were required to indicate on the registration form whether or not the Medicentre could write to the patient’s own GP with details of the consultation. Their failsafe position was that they would write to the GP unless the customer otherwise indicated. In addition they also claimed to take “detailed medical histories” of their new clients.’ They suggested that treatment of patients without access to medical records was commonplace in the NHS, for example in respect of patients using GP out of hours co-operatives or presenting at Accident and Emergency. They estimated that as many as 15 million NHS consultations took place annually without access to GP records.'*° Moreover, in NHS genito-urinary clinics confidentiality is enforced under the National Health Service (Venereal Diseases) Regulations 1974, which impose a statutory obligation on health authorities to take steps to prevent the identification of individuals who have been treated for sexually transmitted diseases.'”’ 87. It seems to us that most of the examples of consultations without records in the NHS mentioned by Sinclair Montrose relate to emergency situations rather than routine appointments. A decision on treatment in an emergency situation without medical records is made taking into 148 tis QQ968-969. See Regulating Private and Voluntary Healthcare, p10. Laing’s Market Review, p119. Other organizations are also now providing, or planning to provide, similar facilities. See The Times, 17.4.99, p61. Ev., p377. DoH Press Release 1999/0294, 18.5.99. 152 By., p248. 193 By., pp248-249. roe Be ee oo Ev. f37T. 58 Ibid. 7 Q963. 150 15]
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