GPs have expressed anger at proposals in the health and care bill that they declare all gifts above the value of £25, suggesting that the new stipulation could turn a simple Christmas present of a bottle of whisky into a bureaucratic nightmare.
The whole attempt to clarify and codify GP gifts is one of the legacies of the Harold Shipman murder case. The Manchester GP, who was convicted of murdering at least 15 of his patients, received several gifts from patients as well as being the beneficiary of a number of wills, one of which he forged.
The proposed rules would bring GPs, who probably benefit from greater patient generosity than any other group in the health service, in line with guidance covering NHS staff.
Prof Mike Pringle, chairman of the Royal College of General Practitioners, said most GPs receive gifts from grateful patients at various times.
The new proposals would mean that even a Christmas present of a case of wine or bottle of whisky might now have to be declared - something that would not only involve unnecessary paperwork, but could also infringe on patient confidentiality.
"I do think that size is important here and £25 is just too low. After all, MPs only have to declare gifts over a value of £250, and it seems to me that what's sauce for the goose is sauce for the gander," he said.
He fully accepted that larger gifts or legacies should be subject to greater scrutiny, but believed this was still something that could be discussed and determined among colleagues within a practice rather than becoming a full-scale managerial issue.
"My worry is that if a generous patient leaves money to a practice the NHS will say you have got that money so we don't need to support you to the same extent."
Patient gifts should be for extra services for that practice and should be decided on by that practice, he said.
In his own practice, for example, patient donations have paid for a defibrillator, a physiotherapy table and heart blood pressure monitors among other things.
"These are all services that are not part of traditional NHS provision, but, as a result of patient gifts, they are being used for the good of patients."
He agreed that self-regulating provisions would not have had much impact on a GP such as Dr Shipman, bent on exploiting his patients, but he did not feel the new guidelines would have an impact either.
"If a dishonest doctor chooses to conceal gifts they can do so whatever the system. But the correct mechanisms for dealing with this are through professional self-regulation," he said.
He hoped the guidelines would lead to an open debate involving all stakeholders.
"This is a significant issue for the profession that needs to be clarified so that people making donations and those receiving them understand very clearly what their moral and legal responsibilities are."
