The British Medical Association (BMA) has thrown the spotlight on the latest low take-up figures for the Choose and Book scheme.
In an article for its membership magazine published on 17 February 2006, the BMA says the service has made a "painfully slow start", with only 67,820 referrals so far out of a 10m total.
It points to examples of low take-up locally. In Bedfordshire and Hertfordshire for example, only 46 referrals were made through the system before Christmas. Across Cumbria and Lancashire the number was 288, while in Essex doctors made 374 bookings through the system, according to the BMA. It says the figures were collated by the Department of Health (DoH).
The BMA article says that DoH director of access Margaret Edwards has been forced to concede that, despite offering a £100,000 incentive for any PCT that could demonstrate 50 percent of referrals being made through the system, only one trust, Durham Dales, hit the target.
VK Singh, chair of Leicestershire and Rutland local medical committee, estimated that about 20 percent of practices in the more rural parts of his area and 10 percent in urban centres have taken up Choose and Book.
"I practise in the city, where practices tend to be smaller and they are not so keen on it because of the demands on their staff,' he told the BMA. "Referral rates tend to be higher and that is the biggest factor in preventing smaller practices from bringing in Choose and Book. Each referral takes longer, which means that we can't afford the time to make the process more complicated."
Chief executive of Avon local medical committee Steve Mercer said his group are "vigorously opposing" Choose and Book, although he did point to some more positive experiences.
"There are a very small number of pilot practices that have adopted full Choose and Book, and one or two seem to be enthusiastic when it runs well," he said. "On the other hand, we know of at least one pilot practice that has withdrawn because the system is impossible and unreliable."
One damning criticism came from Simon Parkinson, secretary of the Worcestershire committee.
"There is little or no activity in the county from either the PCTs or the GPs, thank goodness. I wish Choose and Book would just go away," he said.
Sir Nigel Crisp, the NHS' chief executive, has already admitted to a parliamentary committee that the implementation of Choose and Book is running a year late.
