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Gerada hits back over A&E crisis and tells MPs: 'Practices are fully booked by 8:30am'

Practices are increasingly becoming fully booked for the day by 8:30am because GPs are so overworked, RCGP chair Professor Clare Gerada has warned MPs.

Professor Gerada told the Commons health committee that the profession is becoming ‘demoralised’ over headlines blaming GPs for the current crisis in A&E, and accused health secretary Jeremy Hunt of being ‘lazy’ in blaming the GP contract.

Speaking at the health committee’s inquiry into emergency services, Professor Gerada said: ‘I’m getting emails from colleagues across the country saying their surgeries are fully booked by 8:30am in the morning, which is disgraceful. How can we run an NHS where you cannot get, unless it is an emergency – and by that I mean a dire emergency – an appointment with the GP on the day? This is not because GPs are playing golf, but because they are working 15-hour days.

She added: ‘We see outside our practice queues going down the road, which I have not seen since the flu epidemic. We need a whole system approach, to look at the underinvestment in GP care – we have 9% of the resources for 90% of the activity.’

Professor Gerada attacked Mr Hunt’s recent comments on out-of-hours care and negative headlines in the media, warning that the profession was becoming demoralised.

She told the MPs: ‘It is lazy to blame the 2004 contract… that is 10 years old for a problem that has come about recently, taking into account we’ve seen more or less a flat line in A&E attendance.’

‘We have never stopped delivering out-of-hours care. Who do you think delivers out-of-hours care now? It is the GP. We deliver 90% of all activity in the NHS. But we are not trained to deliver emergency care. You do not want me chopping your leg off in the middle of the night.’

‘It’s demoralising for my profession to be on the front page of some of the newspapers with our feet up.’

She added that ‘many’ GPs across the country wanted to go back to the co-op system ‘mainly because you get a sense of solidarity and we want to do the best for our patients’.  

‘Some are being blocked, some are desperate to do it but feel that they can’t because of the current workforce and we’ll see another exodus of GPs if they are forced to do it,’ she said.

Health minister Dr Dan Poulter said: ‘A&E services had a very bad winter, with additional pressures from flu, norovirus and very bad weather, which stopped some staff from getting into work and created additional pressures for older people in particular.’

‘What we do know is that we have come through the difficult period and data from the last five weeks has shown A&E is back on track, where it needs to be in treating patients in a timely manner.’

Readers' comments (31)

  • anon 12.10
    Ripe to call me naive
    Vaguely insulting I would say
    I am not naive
    We and especially myself, are trying our best

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  • No-One has all of the answers, but the Guardian piece illustrates the problem. This kind of approach plays into the Govt's hands. Do you think most GPs would support your stance or Dr Vautrey's?

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  • Anon 2.16
    You are wrong - it does not "play into Governments
    hands - and its not my role to play politics

    We need to offer an alternative narrative
    A vision for our profession that takes us beyond the current difficulties

    If - and lets say if- you were part of a federation - 10 practices and ran a service for your high risk patients - and say, you were able to provide a full time GP for say, 400 patients - with wrap around, ie good community nursing, social work, geriatrician (named) and other services such as a befriender - either as a single service or spread across the 10 practices. And say, that you provided 24 hour care - in and out of hospital to this population - so not just the GP - so say the geriatrician was the lead for the patient if they become admitted - and say this was resourced fully. And say that this did not mean the GP doing all the night work - in fact it was spread out or even a named person per 10 practices.....then this is very different from what we have now. And say, the rest of OOH - was different - so no HV service, nurse led triage, better links with ED and UCC and ambulance and pharmacists

    This is just one example, there are many others. The point is providing better continiuty of care and sharing the load of OOH.

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  • That's all very well but DOH interpret your comments as "we're willing to take OOH back". I'm yet to meet anyone who supports your view - for a sample of views check out DNUK - you do not have support for this.

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  • " I will not sacrifice the Enterprise. We've made too many compromises already; too many retreats. They invade our space and we fall back. They assimilate entire worlds and we fall back. Not again. The line must be drawn here! This far, no further!"

    Captain Jean-Luc Picardof the USS Enterprise (NCC-1701-D)

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  • @Anonymous | 05 June 2013 4:57pm

    Marvellous what a great movie that was.Wish we had a leader like that....
    Anyhow the point is Clare that on behalf of the entire profession you have admitted culpability.You've admitted that GPs have contributed to the A/E crisis at least in some part.That is a huge faux pas. Ok i admit we're losing the propaganda war.The lies of the Daily Wail keep hurling at us like cruise missiles but i don't expect our leaders to pour kerosene on their own house.

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  • Balraj Sanghera | 05 June 2013 1:10pm

    Well they certainly arent in the CCG I live in. All practices are closed thursday afternoons, there are no evening or weekend surgeries. So at best they are working 4.5 days, plus there are never more than 3 of the 5 GP's actually seeing patients in any given session.

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  • We lost the PR battle long ago.
    It's not in the least surprising because our representative bodies do not use professional PR
    firms to offer stories of interest, to the media ,that show the many injustices we have suffered, how very hard we work and what a good job we do, in very difficult conditions.

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  • I too am surprised by Prof Gerada's naivity.

    Could you not see any such comment relating to GPs ability to improve AED pressure could have been taken the other way ? By suggesting a form on 24/7 care, did you not think you were suggesting we would be prepared to take OOH care back?

    Did you not think as a chair of our profession, you should have choosen your words more carefully?

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  • Clare Gerada has done a fantastic job as Chair but this latest intervention will have the support of very few of her colleagues, certainly not the vast majority of contributors above and the GPC. All the eveidence suggests that GPs are beyond breaking point, with rates of burnout 5 times higher than a decade ago, people taking early retirement, people going abroad, reducing hours and so on. The endless assaults, from revalidation, pensions, rising MPS/MDU subscriptions, and HMG/DoH/the press have taken their toll. Please stop these suggestions now, Clare. We are in real danger of having very few GPs left, so far from the one extra GP per practice you hope for. And the commentators above are absolutely right; what may be 5% now (and I can't see how that would work in practice BTW) will be the thin end of the wedge. HMG will just keep demanding more, more, more until we are offering routine appointments in the middle of the night. Look at recent history, not just of our profession but of other disciplines, and you will see the way things are going. HMG want to offer the public initiatives that will win them votes at the next election while making impossible demands on those that have to provide the service.

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