A GP has claimed the newly-announced incentives on offer for Choose and Book will still make it uneconomical for his practice to take part in the scheme.

Dr David Lewis, a GP in Watford, Hertfordshire, has written to the British Medical Journal to outline his concerns. In the letter he says his practice has calculated that with a patient population of 6400 and approximately 50 elective referrals each week, the partnership would need to spend approximately £4500 in additional staff time each year to administer the scheme. He says that, taking into account the choice and booking directed enhanced service of 95p per patient which begins from April, that would leave his practice with a profit before tax of £1500.

He letter adds: “This is meagre compensation for the three partners who must devote additional time and effort to assist staff to implement Choose and Book for our patients while there is a lack of evidence of the clinical benefit for my patients.”

The letter, one of several critical of Choose and Book in the same issue, also emphasises that GPs have no contractual obligation to offer choice.

Dr Lewis told EHI Primary Care that he had major concerns over the issue of choice and the impact it could have on his local hospital and that while he had been an original enthusiast for e-booking he believed the scheme was currently not fit for purpose.

He added: “I was one of 75% of people in the original Medix survey on the National Programme for IT who said ‘yes please’ to e-booking and I am now also in the majority saying ‘no thank you’.”

Dr Lewis said that, despite the choice initiative launched on 1 January, the practice was referring in the way that it had always done and was still awaiting the arrival of the government’s posters on patients’ right to choose.

He added: “My attitude and that of a lot of my colleagues is that Choose and Book is a white elephant and we will just leave the government to get on with it because there are more important things to worry about.”