I am able to get appointments with my GP/Practise Nurse in the afternoon and evening until 1830 booking either by phone, in person or on the internet up to 6 weeks in advance. This gives me plenty of time to get after work which is 25 miles away. If I have an "emergency" I can phone in the morning and be seen that day.

I am also able to collect my repeat prescriptions after 1500 if I order before 1200 either by phone, in person or on the internet.

But I suppose I am lucky to be served by a 3 doctor country practise covering a large area with the patients spread over that area and not a city/suburban practise with a similar number of patients very close to the practise. Also we don't have Boots. Tesco etc convenient to us.

If my local practise can do this why can't the city/suburban practises or are their patients more demanding and self centred? Or is this another government inspired campaign?

GS, England,

It's very odd that we don't hear the same protests from drs and their representatives regarding records when patients elect to see more than one dr, but on a private basis. Similarly, I don't recall waves of protest from drs when private GP centres set up to offer services to busy commuters - for a fee, of course. This argument is nothing more than old fashioned protectionism in the face of a government that, I hope, will maintain its resolve to challenge the seriously outdated working practices of the medical profession. As for that profession, it is a sad indictment of what are supposed to be some of the best professional minds in the country that they are unable to come up with any better arguments in defence of their current position. I have a simple solution. I will keep a master copy of MY medical records on a data stick so that any dr I choose to see can access and update them. And, don't patronise me and tell me that I'll lose them - I'm not a child!

Bev, Oxford, UK

The NHS pays GP practices around £120 per patient per year. This does not include the cost of drugs. For this patients get between 4-5 appointments, nurse appointments, prescriptions processed, referrals, blood tests, phone access for doctor or nurse advice and much more.

Is there a service that provides better value for money? Within the NHS one appointment with a consultant can cost twice this annual amount. One appointment with a midwife or CPN can cost more than this annual amount. You get three calls to a nurse in NHS Direct or two visits to A&E/walk in centre for this annual amount.

The government is leading a campaign through the media to soften up the public over their views on GP services. This is presumably to open up the provision of these services to private companies. I have absolutely no doubt that this would result in substantially worse care for patients and a doubling/trebling or more of the cost.

Wake up before the government destroys another British asset.

Michael, London,

M E Hoult, Leeds , Yorkshire. Apologies for sounding a bit rude, but this is a nonsense argument. When I was young, there was only one optician in my village. He wasn't very good, but everyone went to him as they perceived that there was no choice. Now, I have a choice from a large range of high street opticians as well as some in supermarkets. As they are in competition, they strive to offer a good service to get and keep my business. The ones in supermarkets are just as good as the rest and have professional examination rooms etc. That they are in a supermarket building brings absolutely nothing negative to the experience and quite a lot positive - eg easy parking. GPs need to fight the government threat by offering their patients a service which is better than any alternative the government might bring in. If they don't, the public will very quickly adapt to Tesco medicine and GPs will become employed drones like the rest of us.

George, Brighton, UK

Here's a novel suggestion. Instead of drs and the BMA jumping up and down in protest every time any attempt is made to shake GPs out of the cosy 1950s world they wish to live in, why not try to radical approach of seeing yourselves as the provider of a service and giving your customers what they want? It's very simple - if you do that they won't be tempted away by Tesco medicine and the like. If you don't, then you will go the same way as the corner shops did when supermarkets began to muscle in on their business. If the govt are serious in their resolve, you've only got one chance to get it right. What's it to be, customer focus, which allows you to remain independent professionals, or employees of some mega-corporation, taking orders and losing any control of your own destiny? Sad thing is, if you allow the latter to happen you'll end up with all of the bad bits of the former choice without any of the benefits.

Graham, Oxford, UK

Oh yes bring on the private players and blow some more millions away just as millions have been squandered on ISTC's and PFI's. Private companies providing OOH services have the highest number of complains registered against them. They are all more interested in money than looking after my health. I want to see my doctor who I trust and know and not any doctor.

P Chhabda, Portsmouth, Hants

NHS Dentists, now NHS GPs - soon a thing of the past. I wish I was a GP in Tesco, instead of seeing 40-50 patients a day I would see only 10, I would enjoy my 6 weeks annual leave, 4 weeks sick leave, 2 weeks study leave and work to rule. Let the managers soak up the headaches from patients in need of care. After All I am the future GP working for Tescos, don't forget to buy your apples, crisps...

Dr Tim Wright, London,

Why not indeed? A great step to more choices of when / where to get quality services. And, of course, less excuses for extended absences or the inconvenience of having to go back all the way home to own GP when one is working in London , for example. About time too to have a bit of competition (in terms of quality care and effectiveness) amongst Doctors so that the les effective ones are 'swept off the street'. BMA's comment about unsafe care is rubbish and big companies are much more likely to embrace safety and quality much more because of maintaining its company image. Roll them out I say!

F Stevens, MK, UK

I work at a gp surgery. I have done so for 6 years. When I started I worked regularly on saturday mornings and the doctors did lots of home visits ,saturday and out of hours cover. With the new contract we were prohibited from opening on saturdays and gp no longer did out of hours cover unless wished. This was a GOVERNMENT led contract. We now have early morning opening to allow workers to come before going to work. Today I had 4 appointment slots for this purpose. Only 1 had been booked. These appointments had been vacant for 1 week! tHIS IS NOT AN UNUSUAL OCCURENCE. We publicise this availability. In my opinion the CBI is making mountains out of molehills. If commuters need on the day attention then there are lots of walk in clinics for them to access, and they do indeed do so.
With more space(we are very cramped) we could offer more to patients. We have been assessed as only having 50% of space required for our list size. Let LLoyds build us new premises and we could share its use

penny price, reading,

Oh dear! The BMA actually admitting how bad the standards of GPs have got!
Isn't this exactly the same scenario as seeing a different Partner at the same surgery?
The only things that will be adversley affected by this sensible change is GPs bank balances.
Doctors' surgeries have a monopoly on areas that they cover. It is not the case that a Doctor can just open up as in most civilised countries.
In all cases of monopoly there is a deteriortion of service combined by an increase in cost.
All said and done there are many good doctors who care about their patients. They are the ones who would benefit from a de-regulation as we voted with our feet.
We still have a Health Care service that is the envy of the world. We just have to stop it's decay and that must come from a changing of attitudes not an increase in funding.
Gawds when they can waste time banning easily cleanable plastic shoes because the are too colourful when patients are dieing of infection there is a problem.

J D S, Cardiff, Wales UK

'The British Medical Association opposed the changes, giving warning that registering with more than one doctor could lead to conflicting diagnoses, inconsistent medical notes and unsafe care.'
i thought medicine was a science

jock, perth,

Seeing doctors' surgeries everywhere I go is likely to make me feel more worried about my health, with the eventual risk of the self-fulfilling prophecy.

Barry, Wallington, UK

Jock, medicine has elements of both art and science. Science in that all sorts of tests, physical (x rays) and chemical are available, but it is the interpretation of these, in conjunction with clinical examination and questioning which, hopefully,leads to a diagnosis and treatment. I have great concerns that, since past medical history will nto be available, mistaken diagnoses will be made. Of course we have the much vaunted computerised medical history whch we will be able to carry around with us, but, like nuclear fusion, I think that this something which might occur in the indeterminate future.
I should add that I am not a physician.

W A Quirke, Derby,

It was the Government's imposition of the advanced access target for GP's that brought about the 48 hour achievement target. Many GP's are now reverting back to the previous system which allows patient to book up to 4 weeks in advance. Again, it was the Governement under the new GP Contract in 2004 that brought about Saturday closing for many GP Surgeries. Perhaps if the NHS negotiators gace a little more thought rather than making changes for change sake we would not be in this mess.

Paul Lardner, London, UK

Unless you have a streamlined computer system - which WILL not be reliable and will be very expensive for the taxpayer, it will lead to poor communication and poor care - will these other services be doing the referral or passing it to their own GP to do the donkey work of referral etc.?
The CBI doesn't state whether missed work time for medical appointments includes hospital appointments, which are by and large Mon-Fri 9-5 - are outpatients/consultants going to be open late evenings/weekends aswell on the NHS for no extra pay(rather than consultants doing their private work out of hours?)?
Patients may WANT more convenience, but it will have to be paid for and why should a GP work for nothing compared to plumbers etc out of hours? It will have to cost the taxpayer a lot more for this service! - maybe charge patients requiring routine appointments outside the core hours of 8am to 6-30pm (not 9-5 as the press have quoted) £150/hour (like solicitors etc.) and they would think again!!

GP, Scotland,

'The British Medical Association opposed the changes, giving warning that registering with more than one doctor could lead to conflicting diagnoses...' What a riduculous statement! Two conflicting diagnoses means that at least one is wrong. So, the BMA think that it is better that a wrong diagnoses goes undetected than allowing the public to recognise that medicine is uncertain in many respects? Either the medical profession have elected a representative body who are not particularly bright and so can't spot the glaring fallacy in their argument, or we are seeing what the BMA are really about - mainaining at all costs a protectionist position favouring drs, at the expense of the best interests of the public.

Clive, Sussex, UK

There are currently a large number of female GPs, who chose General Practice because of the flexibility to work part-time with no out of hours commitment. Many potential future GPs have been driven abroad by the crisis in junior doctors training. All the ideas about extended hours sound interesting, but there has been no consideration about the practical issue of how the extra hours will be staffed. Recent realisation that tired doctors make more mistakes have lead to significant reductions in junior hospital doctors' working hours. Increasing GPs hours will increase the risk of errors and harm to patients. The large amount of money spent on the National Programme for IT have not as yet produced a workable integrated IT solution for the NHS. If patients have 2 GPs, incomplete records will either result in investigations being duplicated, wasting more NHS funding, or each GP assuming that the other would have done the relevant investigations, hence providing substandard care. Repeatedly redesigning the face of primary care wastes millions if not billions of pounds on administration. We have an increasing aging population, which will continue to grow in the next 10 to 20 years. These people do not require extended surgery hours since most are retired. The most cost-effective way to care for them is by providing care in office hours, rather than paying surgery staff extra pay for working on weekends and evenings. It is not an efficient use of public money to spend significant amounts of money to provide extra surgery hours for a minority of working individuals. Rationing is well embedded in the ethos of the NHS because public funding is not unlimited. We need to consider the quality added life years (QALYS) of extended opening and make a rational decision regarding what the NHS can afford, rather than allowing politicians to hijack this important issue to gain votes.

Elizabeth Fong, Hayes, UK

PS I would like to see my MP/bank manager/solicitor/dentist for free on s Sat am or at 11pm at night for free for MY convenience - why are GPs different - it's not a supermarket or call centre!

GP, Scotland,

Yes, I can see it all now.Pop along to your friendly local Tesco Store get your grocerys, then say Oh! by the way can you just have a look at this lump in my breast? your local professional grocer's experience fits all.He will be more informed and quicker than your local doctor? who already knowns your family history more? I think not.Anyone brain dead enough to join in this madness must deserve all they get.These are desperate measures not designed for real illness.They are stop gap measures designed to undermine the NHS system of care.Free at the point of delivery,access for all. Just Madness designed for the brain dead.

M E Hoult, Leeds , Yorkshire

The BMA objections could be overcome with a reliable computer database available to all surgeries at which a patient is registered/attends. Ask the BMA if they would then be satisfied. The answer will reveal much about whether patient care is a facade for old-fashioned protectionism.

If GP surgeries are to be located nearer to places of work, will people be allowed to register with them? If one lives in one health authority area and works in another, will this be possible? If so, why not just do it now: I have doctors near my place of work (or only a short walk away) and would be delighted to register, rather than having to travel by train first.

Jock's understanding of science, however, is clearly flawed: it is quite possible for different scientists to come to different conclusions on the same evidence, although it is likely only in very unusual situations.

JS, Cambridge,

'The British Medical Association opposed the changes, giving warning that registering with more than one doctor could lead to conflicting diagnoses, inconsistent medical notes and unsafe care'
i thought medicine was a science

jock, perth,