Extending opening hours could penalise the most needy patients, says BMA - 10 Sept ‘07

Extending opening hours could penalise the most needy patients, the BMA says today (Monday 10 September).  Responding to the Health Secretary’s statement that he wants GPs to provide extended opening hours, Dr Laurence Buckman, Chairman of the BMA’s General Practitioners Committee, says:

“If practices were to operate routine surgeries over extended hours then other NHS services would need to be open too.  Laboratories would need to be open to make sure patient samples can be dealt with quickly without having to ask the patient to return for another appointment, for example to give a blood sample. Hospital out-patients and X-Ray tests and other services which work with primary care would have to be available too. GPs do not operate on their own and they would also need their surgeries staffed and supported.

“All this will cost a lot of money, never mind the fact that there may not be enough GPs and other NHS staff to actually provide such a service.  The shortage of GPs continues to be a serious issue and addressing that was one of the reasons the new contract was brought in in the first place.”

“This government introduced the new contract and now seems to be trying to destroy its agreement only three years later.  Young doctors are unlikely to want to become GPs if so little trust can be placed in the word of the government.  If the government isn’t willing to consider the workforce issues and the cost implications sensibly then surgeries will have to close at other times of the day.  This will take appointments away from the patients who need and use us the most - the elderly, mothers with young children and those with chronic conditions.”   

The government’s own GP Patient Survey published in July shows the vast majority (84%) of patients are happy with current opening hours and only four in every hundred patients want extended opening hours in the evening.  The survey, which cost £11 million, also showed that only seven out of every hundred patients (from more than 2 million in the survey) wanted Saturday surgeries.

Dr Buckman adds:

“All patients are important but the public must ask if extending hours would be a good use of scarce NHS resources when it is something only a relatively small minority of patients actually want. GPs have never routinely provided Saturday morning surgeries - they were there for emergency care not routine appointments.  The government is deliberately confusing emergency care (which is still provided, largely by GPs working for out of hours services) with routine care offered over extended hours (which has never been available).  GPs resent the repeated slur that we only offer office hours, as many GPs and their teams struggle to provide surgeries between 8.30am and 6.30pm with longer and more complex consultations and a higher quality outcome.  In any event, Primary Care Organisations (PCOs) have had the ability under the new contract to negotiate with GPs to establish Local Enhanced Services (LES) so GPs could provide extra services for local people. Very few PCOs have chosen to use their resources in this way, but some have reached agreement on Saturday or evening opening with local practices.

“The BMA's GPs Committee (GPC) is willing to talk to the Secretary of State to discuss all these issues and to see if there is a way forward.  It is not helpful for the Department of Health to continue to criticise GPs without explaining to the public the consequences of government proposals.  The Government has not approached the BMA for these talks and made no attempt to engage with us on this matter.  They seem to prefer to shoot first and consider the issues later.”

Back to news index