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Labour pledges £100m to reintroduce 48-hour target to see GP

Labour leader Ed Miliband has pledged to end the ‘scandal’ of patients waiting more than a week for a GP appointment and reintroduce a right for patients to see a GP within 48 hours.

Mr Miliband announced that a Labour government would reintroduce the target scrapped in June 2010 for patients to have a guaranteed appointment at their GP surgery within 48 hours.

He also said that patients would gain a right to be seen by a GP on the same day if they need to be seen quickly and be able to book appointments more than 48 hours ahead ‘with the GP of their choice’.

The Labour leader pledged to invest an extra £100m a year in GP practices to pay for an additional 3m GP appointments every year.

He said this additional funding will come from repealing the requirements to use competition in the NHS and cutting back on what he called ‘quangos’, such as Monitor, the Trust Development Authority and Commissioning Support Units.

He said: ‘I can announce the next Labour government will put in place a new set of standards: a same-day consultation with your GP surgery with a guarantee of a GP appointment if you need it that day, a GP appointment guaranteed for all within 48 hours, and the right to book further ahead with the GP of your choice if your priority is to plan ahead or to see your preferred doctor.

‘This will be better for patients, because they have better access to their GP surgery; better for the NHS, because it will save money currently spent in A&E; and better for Britain, because it is the kind of health service we need.’

He added: ‘A quarter of the public now say they can’t get an appointment in the same week. It’s a scandal that people are waiting that long, it is not how our NHS, the pride of Britain, should work.’

He also promised to make the NHS a more integrated service. He said: ‘Our plan for the long-term of the NHS starts by making sure that physical health, mental health and social care – services which have stood apart for too long - work together. Just think of the difference it could make. If a simple grab rail is placed in someone’s hall at home, that can stop a fall that could lead to that person breaking a bone, keeping them out of hospital, saving them the pain and the suffering, and saving the NHS thousands of pounds.’

RCGP chair Dr Maureen Baker said that she welcomed the announcement of more funding for general practice.

But she added: ‘While we welcome Mr Miliband’s announcement it must not be another “sticking plaster” solution but part of a broader, long-term, shift in investment. Ultimately, general practice needs 11% of the NHS budget by 2017 in order to cut waiting times and guarantee safe care for our patients.

‘We particularly welcome Mr Milliband’s pledge to scrap the marketization of the NHS, something our members, across the country, have long said is unworkable and undermining their ability to provide joined-up patient care.

‘The college looks forward to working with politicians from all political parties to discuss how general practice can be funded to provide better and speedier access for patients, in order to take pressure off our hospitals and allow patients to be treated in their communities.’

GPC chair Dr Chaand Nagpaul said the targets were ‘misguided’ and ignored the real crisis going on in general practice.

Dr Nagpaul said: ‘I would very much want to have a discussion with the shadow health secretary Andy Burnham in particular, as I think these suggestions are misguided and are failing to address the fundamental problem which is the crisis in general practice.

‘Issues around 48-hour targets and so on are just an irrelevance. The worst thing you can do when you’ve got a system under pressure, where demand outstrips capacity, is to create such targets that are likely to result in counterproductive, perverse behaviour - this is the last thing we need.’

He added: ‘What is really important is to address the fundamental lack of investment - £100 million is 0.1% of the NHS budget, it’s a tiny sum in the totality of what general practice is expected to deliver.

‘We need to look at the workforce, manage demand and ensure GPs can deliver the most appropriate care within the constraints they have – not stoke up demand that is not achieveable, leads to perverse behaviours and often ends up denying care to those that most need it.’

Meanwhile, commenting on Labour’s plans to overhaul the NHS competition regime, NHS Clinical Commissioners co-chair Dr Steve Kell said: ‘Labour raise[s] some interesting points about competition and we know from our members the unnecessary burden and cost that it can place on the system if it is not used or understood properly.’

‘Clinical commissioners are faced with the decision to tender local services every day, and have found there are a number of practical difficulties with the current system when trying to secure the best outcome for patients. It is sometimes unclear to commissioners whether they are simply free to commission from a market, or whether they have to commission in order to make a market operate.’

Related images

  • Ed Miliband - online

Readers' comments (86)

  • Una Coales

    I just voted UKIP on my postal EU ballot. At least the health advisor for Scotland UKIP is a medic, one of us! Meeting the Tories in 2 weeks. I am giving them one more chance to get it right or else I defect all the way next general election.

    Labour lost my vote when they imposed PFI debts on NHS hospitals and drove managers mental trying to tick boxes linked to income to meet insane interest payments at the cost of patient lives!

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  • Just when we thought J Hunt was clueless, out comes Milli B. If he believes GPs are going to deliver this nonsense he might as well believe in Father Christmas.
    £100m !! If there are 40000 GPs in England that would be £2500 each - minus tax and pension contributions that would be £1k each. Any takers?
    There would not even be the manpower to deliver this or are we going to do away with all pre-bookable appointments? Now that would certainly not please the middle aged commuting swing voter as he'll find out at the next elections.
    It would actually be funny if it wasn't for the fact that these fantasists are ruling OUR country and lives. That's why we're in the sh.. and nothing works.Neurosurgeons please, please pioneer the brain transplant or amputation at least.

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  • sigh ...

    as everyone agrees we have a problem of high demand with shrinking supply.

    what solutions do politicians propose? tackling demand - No, increasing supply - No.

    The politicians solution is to increase demand even more.

    It doesn't matter who you vote for we are stuffed.

    our last chance is to stand together and look at alternatives to the NHS contract as clearly we are on our own.

    I hope GP partners will think about where the profession is headed as there is no new money to bail out primary care and work load looks set to increase indefinitely with reducing incomes for the forseable future. worrying about what the media or patients think won't matter if you can't afford to put bread on the table.

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  • I think the answer is straightforward. We have to keep our practices profitable just like any other business. In a world where income is stagnant or down and expenditure is increasing and there are no other realistic ways of boosting income the only way is to reduce expenditure. We all know that staff costs, especially clinical staff is by far the greatest cost and the only way to significantly reduce expenditure is to reduce clinicians. Let's face it, we're not going to survive this onslaught by saving a bit on consumables or sharing a few back room staff as accountants and idealists want to make us believe.
    Let's cut down on staff, appointments and direct them towards the A&Es and DGHs the same way they have turfed out patients over the last decade to us.
    The practices that won't take that approach will be the ones that will have to close down and I firmly believe that as soon as practices will go down the public will turn on the politicians big time and it will be us, not A&Es they will try to save.
    Each of their voters will have a GP and know them, far fewer will have been to A&E.
    In the meantime it will be survival of the fittest I fear.
    This is not why we went into medicine, but many of us have chosen to run businesses at the same time and ultimately we have to take care of the livelihoods of our families and our employees.
    Let's stop being dreamers.

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  • GP'S are self employed. it is their shop.they need to fulfill the demand . minor elements may be minor to gp's. not to patients. when your car sqiucks you take it to garage.. it may be minor for garage. 48 hour access is possible.and is already achieved by most gp's . they will pay for this. good news if labour wins.

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  • If we could lose the next seven days then EVERY patient will be seeing a GP within 48 hours. What I mean is that every patient is already being seen within 48 hours of a point in time. All that needs to be done is to make that point of time when the appointment is made! It is possible and that is evidenced by the fact that many practices are already doing it. The tricky bit is the transition from the current process to one which provides an appointment within 48.
    I hate to say it but GPs are just too resistant to change. You can shoot me down for saying that and I'm sure many will but it's completely true. I am a huge fan of GP's and agree that the government are giving you a really hard time and coming up with ridiculous policies but sometimes you really don't help yourselves!

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  • Anon@8.18: 48 hour access is possible and even desirable but only if used for need and not want. As a locum/sessional GP, you will be paid per hour. GP partners have no limit on number of patients seen - if we add in all the minor self-limiting illnesses because politicians tell them it is their right to see a GP whenever, the system will crumble or the less vociferous (and possibly genuinely needing attention) will lose. We are professionals. It's not a shop or a garage and we are not paid per consultation. I would prefer to spend my time with those who need me than limit access to the ill by working to ridiculous political targets.

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  • Anon manager@10.29 - I think you are missing the point. We are already seeing patients according to clinical need and adding them as extras if the next routine appointment is too distant. Milliband has announced that patients will have the "right" to see their GP within 48 hours which is an entirely different concept. Please excuse my "resistance to change" if I object to being used for political point scoring rather than being allowed to do my job.

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  • Took Early Retirement

    8:18- yes, you take the car to the garage and you PAY for the work done.

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  • As a patient I find it frustrating that my own GP can't see me for a week (sometimes over a week) but I accept it. I was suffering from depression a few years ago and only wanted to see my GP so due to it not being life threatening (I wasn’t quite suicidal) I was happy to wait a week. If I had something that really needed seeing to then I would expect to be able to see a GP straight away although I would accept that it will probably not be my GP. My son was suffering from bad chest pain that was causing him some discomfort and I wanted him to be seen straight away but the first appointment I was offered was 3 days away. I only got seen the same day after making a fuss. I was given the last "emergency" appointment that they like to keep for real emergencies!!! When I asked out of interest why I couldn’t be given an emergency appointment the next day I was told that they only get issued the same day! Great system! I spoke to a practice manager friend of mine and he said his practice runs mainly same day appointments. His practice was in a city and of a very similar size but actually in a much more deprived area. I also had a conversation with a GP who said that since they’d introduced a triage system they’d reduced from an appointment system very similar to that at my practice to same day appointments or at least within 48 hours. He also said that he now works less hours as a result. This proves that it is achievable if done properly. I personally do not feel that it is acceptable that there should be such a range in service between different practices. If it’s achievable in one it will be achievable in all. I really don’t think that the 48 hour rule is unreasonable, it's not about providing any more appointments it just about managing how they are booked more efficiently. What I do think is that something needs to be done about demand. I know that there are elderly who probably make an appointment for a bit of human interaction as much as anything else and I know there are patients who attend with nothing more than a cold that they have been suffering with for a couple days and these people need to be educated! I saw one post on face book stating that someone had a sore throat and because they couldn’t get their GP they were off to A&E. I really didn’t believe that was happening until I read that post and yes I did post a less than sympathetic response. I think that both these issues should be addressed together the access strategy should cross the entire health service including social care who should be ensuring that the elderly have enough human contact that they don’t need to see the GP. I don’t think anyone would say that it’ll be easy but please don’t tell me it’s not achievable when so many are already doing it!

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