Editor's blog Thursday 17 September 2009: Why Andy Burnham is turning up: to announce fully free choice of GP

Good morning. The Independent has the story of why Andy Burnham is turning up to today's 'back-to-school' debate at the Kings Fund.

It is so he can make an announcement that patients will be able to choose to register with any GP anywhere, including close to a place of work.

It's hard to know whether to laugh or cry at the idea that this is a major policy priority. Given GPs' well-known fondness for working for free, the likelihood of this proving cost-neutral seems very slim indeed. And we are in a recession so bad that reality has finally dawned on Gordon Brown that he needs to be honest about the fact there will be cuts in pubic spending.

He has not yet mentioned the need for tax rises beyond the long-announced 0.5 pence on NI and 50p rate for earners pulling in over £150,000. Not to mention the VAT re-set to 17.5% (or higher?) But it's coming.

What GPs do
Let's recap on most of GPs' workload. Sigh. It is the elderly and the chronically ill (particularly with more than one condition); the significant majority of whom do not work hugely significant distances from where they work. It is expectant mothers and those with young children.

Professor Paul Corrigan gave this issue a lot of profile when he was Tony Blair's special adviser after Simon Stevens. It relies on three things: available funding; clear demand; and potential supply.

Of the first of these, the NHS is going to have to live within its means. Politicians claim these will not be reduced. We shall see. Few people I speak to think the NHS will have the promised immunity.

Of the second, there is anecdotal comment that it is needed. I am unaware that it amounts to evidence.

Of the third, I wonder how many urban practices feel they have ample spare capacity, either in staffing or in sheer physical space.

More to the point, why did we invent walk-in centres and polyclinics?

And what's wrong with a nice trip to A&E, eh? (Joking here, non-irony people).

This is bloody stupid.