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Remember the days when shops were open for the convenience only of the people who worked in them and providing an “out of hours” service was an alien concept? Any private sector firm that had not adapted its hours to suit its customers in recent years would have gone out of business. Some did. But the public sector is different. Its customers - taxpayers who pay for the services - have to take what they get. The National Health Service is going backwards in serving the needs of patients, certainly as far as family doctors are concerned.
This week the Department of Health will release the General Practice Workload Survey, the first for 15 years. It will show that GPs, who earn an average of more than £100,000 a year, are working 15% fewer hours than in John Major’s day. Most notably, as a result of an overgenerous contract with this government that gave GPs more than they could have dreamt of, few of them work evenings or weekends. GPs are the gatekeepers of the NHS. But even getting to the gate means, for most people, the inconvenience of taking time off work. Some 3.5m working days are lost each year because of this, according to the CBI, the business organisation.
The British Medical Association, on behalf of the NHS’s producer interests, says there is no demand for evening and weekend surgeries. It cites a health department survey showing that 84% of patients are happy with the current opening hours and warns that diverting GPs to evening and weekend appointments would hurt the neediest - those with long-term conditions and parents with young children. But most GP practices are big enough to offer daytime and “out of hours” appointments. Even if only a minority want them, which we doubt, why should they be ignored? Before taking over as prime minister Gordon Brown said he would take steps to provide evening, weekend and early morning surgeries. Since then he has fallen silent. He needs to take such steps now.
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Hear, Hear Jonathan. If the stats don't suit - ignore them! If politicians had 84% satisfaction ratings we would all fall over in disbelief!
Gordon Brown's "review" will no doubt ignore the basic tenets of affordability and be as populist as Blair's last failed attempts.
The time has come for an open and honest debate about what the NHS can and cannot afford. 24 hour GP access, iPods for druggies who stay clean, air con for COPD sufferers or .... herceptin. Let the public decide.
Richard, Doncaster,
I have just rented a flat. If I wanted to pick up the keys outside office hours, I would have had to pay the letting agent £100 plus VAT for the privilege. Can you see your solicitor or dentist out of hours without a hefty penalty fee? What about a plumber or electrician? Why are doctors different - oh yes, we all think it's free and so do not value it.
Stephen, London, UK
Why not allow GPs to charge for out-of-hours appointments? The payment would be a premium for convenience, the basic cost of the consultation being paid for by the NHS in the same way as any other. The right to do this could be constrained by requiring (say) 80% of all appointments of an NHS practise to carry no charge, so you would not be compromising the NHS principles.
It's quite understandable that GPs don't want to work out-of-hours, but also that some people would greatly value such appointments. A market price for such appointments is the best way of resolving this conflict.
Chris, London,
Ah, CCTV of Nottingham, perhaps the 13K will be unemployed because of the £100+ being paid to those in post...there is only so much money in the pot, and those with their snouts in the trough (to change the metaphor) are not likely to move aside to let the others get a look-in, are they?
J.Fletcher, Canterbury, UK
If you compare GPs earnings for the very hard and stressful work they do and the years and years of sleepless nights training to, say, those who went to university for three years and graduated to a career in investment banking earnining ten times more than a GP, you will realise that GPs are excellent value for money indeed!
I agree with CCTV above that you should turn your attention to the chaos which will be in all hospitals around the country when there will be a shortage of doctors on the shop floor while up to 14,000 highly qualified, able and dedicated doctors are being made unemployed to save money!
Sam, Brighton, UK
There are lots of GPs doing out-of-hours work in cooperatives. Your picture is misleading. You should also ask about their clerical duties filling out forms for the government in its deforestation projects of rendering all human life to multiple choice tests.
You might have focussed on the 13000 trainee doctors who will be unemployed on Wednesday and the difficult times ahead in hospitals - why you ignore it is unclear
CCTV, Nottingham, England
'Even if only a minority want them, which we doubt.....' Is the ST now some offshoot of the Flat Earth Society? The DOH spent 11 million quid (of taxpayer's money) on a patient survey where the questions were designed to extract the answer that weekend & evening opening was what patients wanted but look what happened! 84% said no thanks. We are not private sector. We do not charge for our services. Our resources are pre-determined & finite. I cannot reduce staffing levels in the day so that I have receptionists, nursing staff, secretarial & administration staff available in the evenings, nor can I provide a service without them, so we need extra staff - where does the money come from? Please don't say 'out of your inflated salary' because the numbers just don't add up.
People are off work 'cos they're ill Duh! That's why most of them are seeing their GP. AND its a 10 minute appointment - even allowing for travel & late running the CBI stats are being selectively quoted I wonder why?
Jonathan, Bath, UK