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Independents' Day

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.’


Readers' comments (12)

  • We can dance around this over and over again. The simple fact is:

    Not enough GPs = Not enough appointments
    Worsening T+Cs = less GPs entering the profession, more leaving
    Recruitment crisis well underway

    Having 2h/12h/24h/7d targets etc is irrelevant.

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  • You are going to need a lot more GPs mate.When mother hubbard goes to the cupboard their are no GPs therein to provide what you promise.Primary care is screwed(and th NHS) who ever gets in the next election.

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  • Took Early Retirement

    Patients, on the whole, hated the system.

    DOI- None 85 days till I get out of the salt mine and watch recent history repeat itself. What cretins the politicians are!

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  • I really need to quit my job, constant micromanagement from politician with little insight is destroying my profession

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  • Peter Swinyard

    As Richard Vautrey rightly says, simplistic gesture politics ("We promise that you can see a GP within 48 hours") is complete nonsense and distorts the system in a way which is not to the patients' benefit. The worst time we had with our appt system was with "Advanced Access" - ie 48 hour target - which we quietly dropped and ignored as it intensified the 8am scrum and did nothing for patients. The best time is with the Patient Access GP triage system.
    Nothing is perfect - but we are at last coping with talking to patients within 24-48 hours even at massive peak demand times - and seeing in timely fashion as needed.
    Please STOP trying to tell us how to do our jobs, politicians of all parties and their bag carriers.
    Strangely, those of us still working as GPs actually DO want to be available, accessible to patients and move heaven and earth to achieve thiseven at the cost of personal burnout.
    I don't tell you how to run your political parties.
    Don't you tell me how to run my practice.
    Set us aims if you like, aspirations, big picture stuff. Give us the necessary resources.
    Then BUTT OUT and let us deliver.

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  • Vinci Ho

    (1) First of all , you really think bringing this target back plus the riffraff of getting GPs to write reports after reports every time they sent patients to hospitals , will solve the problem in A/E?? What if the learning points from these 'significant events' are actually needing more doctors in A/E and more GPs instead?
    (2) Abolishing HSCB is a no brainer for you mate but you will have to come up with something far better than this to earn back people's trust on your party.
    (3) the fact this current government is betraying all principles of NHS( remember what William Beveridge said about the 5 giant evils- Squalor, Want, Idleness, Ignorance and Disease ??) and spread the evils through the most , DOES NOT guarantee your party an election to win outright.
    (4)Exactly how is your party going to reinvest the £1billion back into primary care ? I am not sure people are having absolute faith.Respect what you had done for the 96 of LFC even though you are an Evertonian but this is about flying the flag of NHS....

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  • We operate the patient access triage system very successfully. It has improved access immeasurably for people who need to be seen. However, like building roads, it has created its own demand,

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  • We operate the patient access triage system very successfully. It has improved access immeasurably for people who need to be seen. However, like building roads, it has created its own demand, to the point where we are dangerously overworked - despite having added 3 GP sessions and 2 Nurse Practitioner sessions over the last 12 months - without any extra funding.
    Patients have forgotten where the medicine cabinet is being too used to being spoon fed by an excellent GP service. We need investment to allow this excellent service to continue - both in GP's, nurse practitioners and extra highly skilled community nurses if we are to have any chance of keeping primary care alive.

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  • Interesting to read about patient access triage system. We moved away from triage system few years back and now have a policy of seeing everyone same day if they wish to BUT they come to the 'Sit & Wait ' clinic and be prepared to wait. Depending on the day and how many turn up wait can be upto an hour . On the other hand patient who want continuity and prebook appointments have a month of appointment to book ahead. It's very busy ( am sure everywhere is) but nothing is postponed to tomorrow .....don't know when this system will fail!!!!!!!

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  • Peter Swinyard

    Sit & wait. Otherwise known as open surgery. Stopped doing in November as could not cope with 55 + face to face in a morning then 25 booked in pm plus visits etc. Now seeing those who need to be seen. Demand now such that I fear open surgeries may no longer work in small practices like mine. Also not good for patients to wait hours. Better to have quick gp access by phone then timely face to face for the 38% who need it.

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