WHAT happens when you ask people’s opinion and you don’t like the answer? It’s a quandary the Government may increasingly face, with its seeming obsession over asking the public for their views on just about everything.

GP (Sept 21) reports that patients prefer small practices, a finding that flies in the face of the Government’s plans for polyclinics and supersurgeries. The Improving Practice Questionnaire, which questioned patients at 2,500 practices, shows that satisfaction levels are higher in small practices, particularly in relation to telephone and 48-hour access, the ability to see their first choice of practitioner and waiting times.

Dr Michael Taylor, chairman of the Family Doctor Association, formerly the Small Practices Association, says the data is “excellent ammunition” for small practices. “The Department of Health talks of a patient-led NHS, then develops policies that ride roughshod over small practices.”

Health Service Journal (Sept 20) reports on two studies which say the Government’s vision of a patient-centred NHS is a long way from becoming a reality. Angela Coulter, chief executive of the Picker Institute, which coordinates the annual patient survey, says: “Despite positive read-outs in many areas of care, patient engagement in decisions has flatlined. It means the rhetoric of patient-centredness has a hollow core.” Patients say they are not involved in decisions as much as they want to be.

The Health Foundation says patient engagement has improved, but the Government is still not listening enough to what patients want, which creates “a mismatch between what the public and patients say are their priorities for quality and what the Government has chosen as being most important in policy initiatives”.

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