Burnham considering permanent 48-hour appointment target
Labour would consider permanently bringing back the 48-hour GP appointment target should they be successful in the next election, the shadow health secretary has said.
Andy Burnham hinted that Labour would stop an erosion of the primary care budget that has taken place under the Coalition Government to support the move.
The controversial 48-hour target, first introduced under Labour, was scrapped in June 2010 soon after the Coalition came into government, and Mr Burnham called for it to be temporarily reintroduced to ease pressure on A&E practices over the winter - a move criticised by the RCGP.
Today, speaking at the press launch of Sir John Oldham’s recommendations for Labour’s new health policy, Mr Burnham said that the ‘£1bn’ worth of funding removed from primary care since the Coalition Government took power had a ‘worrying’ effect on patients’ ability to get a GP appointment.
He said: ‘I think it is quite worrying what has happened to primary care under this Government. The simple fact is it has got much harder to get a GP appointment under [Prime Minister] David Cameron, and the Patient Association is now talking about a week becoming the norm.’
‘[Labour] had clear guarantees in place… We gave people a guarantee of an appointment within 48 hours and also the chance to book ahead, and book an appointment, and both of those things were scrapped immediately.’
Asked whether he would bring the target back if the Labour Party is successful in the 2015 election, Mr Burnham told Pulse: ‘I would certainly consider it, yeah absolutely. It was our policy before and so we’ll certainly consider it.’
It comes as the Coalition rejected an earlier suggestion from Mr Burnham for the target to be brought back temporarily to help cope with pressures on A&E departments this winter.
Mr Burnham said: ‘We called for it to be reintroduced temporarily for this winter because we felt that too many people were being told on the phone that they couldn’t have an appointment and they then were going to A&E. I think at this stage we haven’t made any firm commitments about permanently bringing the targets back but I think they were very valued by the public, in that you could get an appointment when you wanted one, and the current system is not tenable, basically.’
Further, asked whether a Labour Government would also be prepared to fund GPs to provide improved access, Mr Burnham said: ‘The RCGP are talking about £1bn of cuts to the primary care budget and we are seeing that, we are seeing the consequences of that. Wherever I go I hear people say to me “I am ringing the surgery at nine o’clock every morning and I am just being told that there is nothing available”. That is a consequence of the huge financial cut and the removal of those patient guarantees.’
‘The model that [Sir] John is putting forward here is based on primary care taking an expanded role, with the GP at the centre. You know, a shift of resources from the secondary care space and the whole of the community and the primary care setting.’
However, GPC deputy chair Dr Richard Vautrey strongly advised against a revival of the target.
He said: ‘I think that would be a mistake. The evidence, when targets were present, was that they had lots of perverse incentives and consequences and it meant patients complained that they were not able to book ahead with their chosen GP.’
‘Instead they were forced to make appointments on the day, and appointments were prioritised for same-day conditions, which were often self-limiting conditions that patients could have actually dealt with, with appropriate self care advice. Whereas the patients who wanted a long-term relationship with a practitioner, who wanted continuity of care, were denied that because of the targets.’
‘Superficial targets have superficial attractions which have unintended consequences and that’s why that target was dropped, because it didn’t work.’
Mr Burnham also said he would make changes to the NHS Constitution.
He said: ‘One thing I am looking at is that we might put new rights, or entitlements, within the NHS Constitution, such as the right to end your life at home. This could be one of the ways in which whole-person care becomes a reality as the system then has to find ways amongst themselves to give people those fundamental choices.’
The shadow health secretary also addressed his plans to repeal the Health and Social Care Act 2012, saying it was consistent with the decision to retain CCGs.
He said: ‘It is totally consistent. The Bill that repeals the 2012 Act would carry forward the clauses that created CCGs and health and wellbeing boards. We are just giving those organisations a new job to do, we don’t need a new organisation delivering new policy. The rest of it has to go.’
Aside from scrapping Section 75 and the role of the Office of Fair Trading, Mr Burnham said: ‘We have to reinstate the secretary of state’s duty to provide, we’ve got to remove the freedom of NHS hospitals to get half of their income from treating private patients.’
‘The market is not the answer to 21st century care, the future demands integration. The insistence on open tendering and market-based healthcare delivers the opposite – it delivers fragmentation – and that’s a very clear difference between this policy and the policy of the current Government.’