Personal view: Dr Bhupinder Mangat

Dr Bhupinder Mangat

Prime Minister Gordon Brown’s announcement that he wants the public to use new technology to provide feedback on public services has caused considerable debate. Some commentators have been horrified by the idea of patients rating hospitals and GPs. Dr Bhupinder Mangat, a GP in Hounslow, is not one of them.

Before I make my points on why I think online patient feedback for GP services is a good and inevitable idea, I need to declare my interests.

I have had some limited – but unpaid – involvement with the NHS website, NHS Choices. I have done some voluntary radio broadcasts in my area of Southall for a community project designed to increase access to healthcare information for people from ethnic minority backgrounds.

I have also helped NHS Choices with the promotion of its online guides for chronic medical conditions. I believe this type of internet health information is an excellent way of providing patients with information on complex conditions, often at a time when they are anxious and concerned.

Talking about a revolution

There is an information revolution going on that is fuelled by the internet. This has transformed the ability of people to find information that was previously hard to come by and to communicate it to others.

People seeking information through accurate websites that are managed properly is a good thing. And getting the views of patients on their treatment is undeniably beneficial; whether it’s through a letter, a meeting, a questionnaire, or the internet – the more, the better.

Everyone involved with patient care is keen to involve patients more, to find out what their views are so that we can improve what we are doing, if that is required of us. But let us be honest. Participation is traditionally low.

We want to hear from everyone, but very few young people come to meetings and fill in the forms we leave for them. Internet feedback, whatever its flaws, engages with people who wouldn’t normally get involved.

The internet has forged a new and more effective way of communication for many people who may have previously felt isolated. While there are those who do not have access to the internet, it is able to reach people from different backgrounds, particularly ethnic minority groups.

Doctors need to get involved

I think that this is a debate that GPs need to have. As a GP in an area with a high ethnic population, any scheme which enhances the chance for people to leave feedback seems sensible to me.

But what about the argument that people will just leave negative comments, and that they don’t understand the complexities of medical management? I think they should still have this opportunity to tell us what they are thinking.

If I am failing to address my patients’ needs and concerns, I should know about this. It is my role as a doctor to explain to patients how their disease will affect them and what they can do to help manage their condition. The internet is almost designed for this sort of dialogue.

Many patients, because they don’t understand the medical complexities, don’t challenge something they feel uncomfortable with in a consultation. The impersonal nature of the internet can empower people to challenge decisions and assumptions that they may not have had the confidence to challenge in person.

A practice which deals with feedback constructively, responding to and seeking to resolve issues, could nip in the bud disputes that would otherwise escalate to formal complaints and worse. It is important to offer patients a real voice, in a way that is accessible to them.

What are we afraid of, anyway?

No system is perfect and I anticipate there will be problems with the introduction of patient feedback and ratings. There may be comments that are not fair; perhaps even some malicious comments.

I don’t want the good reputation of my practice and morale of my staff to be in any way harmed by these. When NHS Choices says that it is building in safeguards, I want to see them working in practice. If they don’t work, then the site must review its procedures.

However, we live in an internet obsessed society and it is inevitable that people will talk about their GP services online, as they talk about everything else.

Also, we know that the vast majority of our patients are happy with our service. GPs are among the most respected people in our society, so why aren’t we welcoming this move, to demonstrate the confidence our patients have in us? Let’s have a little bit of confidence in them.

Dr Bhupinger Mangat is a partner at at Dr Mangat, BS and Partner Practice in Hounslow.  Dr Mangat has worked as a GP in England since 1975. He is a fellow of the Royal College of Obstetricians and Gynaecogists. 

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