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Gold, incentives and meh

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.’


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  • Ed Miliband - online

Readers' comments (86)

  • Dr Hodges
    It was something he'd complained of to varying degrees intermittently for some months but it had never reached that severity before and it wasn't constant. It would come and go but at it its worst he was distressed although that might only last for a minute and then subside. The majic Calpol seemed to help massively to eleviate the pain. I weighed it up and felt it warranted an urgent GP consultation but not a visit to A&E. The diagnosis, if your interested, was Chondritis which was something I'd obviously never heard of before. The example might be a bad one but my point is that I felt that the appointment system at my practice was poor. I've had issues with it for years but as a conscientious patient I dont feel thats fair. I do think that an enormous part of the problem is patients taking up unnecessary appointments but I don't see my practice doing anything to address that problem yet I am aware of some that have, have resolved the problem and feel that they have a much better work life balance for doing so.

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  • Nothing wrong with 48 hour access.
    Subject to triage of course.

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  • 1 phone triage = 1 appointment .

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  • another spin before elections-he will need more than 3 million to fulfil his dreams--if he has money we will find time

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  • Just Your Average Joe

    48hr access possible with triage to allow those who need to be seen, to be seen - but unlimited access not possible or wanted.

    As with a child throwing a tantrum - giving them what they want, now, is never going to end well.

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  • Theres a lot of comments here on Pulse of the dangers of big companies taking over Genral Practice. What we have to remember is what these companies stand for. Most will try and remain ethical and moral, but the main purpose of running a business is financial.
    For our 30,000 GP`s to suddenly become salaried is a massive expense. Most of us own our buildings. There is no "goodwill" clause in General Practice.If we were a partnership of lawyers, to be taken over by a nother firm would involve a payment for assets, i.e the building , fixtures/equipment, and also a price for the worth of the business. Genral praictice is exempt from that worth.( something I am sure someone could take to a body such as e.g. monopolys commision).
    That aside it would run into big monies to buy us all out. even if several went bankrupt.
    There is also the issue of the EWTD. 48 hrs a week max.
    Training up specialise nursing staff to deal with minor illness would be a massive undertaking. Whilst our practice nurses are excellant To have the depth and breath of knowledge of a Full time GP would require 3 to 4 nurses each specialising in different areas, together with the ability to cost cover. Even at 30 k per annum ( ours are paid a lot more due to their experiance) , 4 nurses would cost more than your average GP salary
    Taking general Practice and turning us all salaried semms to be the game the goverment is playing.
    The implications for patients are obvious, but the cost financially would be massive.
    Asking patients to pay a contribution would make sense, but every MP knows it would be political suicide, as their priority is reelection rather than governing in a cost efficective and moral manner.
    Our unions really need to get the point across that their is a reason Primary care has lasted this long in the UK.
    A knackered and middle career GP, whi is nervous about the future.

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