What previously was a matter of professional self-regulation is soon to be taken over by new government-regulated bodies. The conduct of GPs, in particular, will soon be subject to much greater bureaucratic scrutiny thanks to pending government legislation. The legislation will enforce the appointment of a ‘responsible officer’ for every doctor’s office in the United Kingdom.

This is all about risk. By comparison: GPs in Germany pay only about 400 Euro per year for professional insurance. British GPs pay as much every month. The best explanation for this huge discrepancy seems to be the strict gatekeeper role of GPs in the UK. Whereas in Germany everybody is eligible to see a specialist of his or her choice, in Britain NHS (and even private) patients need a referral from their GP for each contact with a specialist. This inevitably results in delays for state-of-the-art diagnosis, often leading to unnecessary suffering and postponed treatment. This is certainly the weakest point of the paternalistic NHS system, which incorrectly prides itself on equal access to health care.

Trying to mend this with a validation system overseen by an imposed, personal ‘responsible officer’ for each doctor is likely to make things even worse. GPs managed to retain their basic freedom as self-employed contractors in 1948 when the NHS was set up, but are set to lose as responsibility for their conduct is transferred to a state-regulated officer. Inevitably, doctors will be infantilized in the same way as NHS patients have always been – and patients’ access to specialist care will be limited even further. Because GPs just don’t have the same diagnostic equipment at their disposal as hospital doctors, putting them in charge of specialist referrals is, at best, an imperfect system. But putting government-sanctioned ‘responsible officers’ in charge is even worse - ‘responsible officers’ will not be able to make effective clinical decisions because they will, most likely, not even be trained doctors.

A market-based solution would be to give patients open access to specialist care. They would be happy to exercise their natural responsibility for themselves.