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At the heart of general practice since 1960

Seven-day access is masking, not solving, GPs’ problems

Dr Zahid Chauhan writes

From Dr Zahid Chauhan, Oldham

Reducing waiting times and ensuring patients are seen and treated as quickly as possible is surely a goal we all share, regardless of political allegiance.

David Cameron’s promise that everyone in England will have access to a GP appointment seven days a week by 2020 was no doubt music to the ears of those who have waited days - or even weeks - to see their family doctor.

But while Cameron’s aims seem laudable, his methods are highly questionable. Set against a backdrop of government pressures and cuts, where NHS resources are stretched to their limit and where the health service is haemorrhaging GPs - his aim is not only unachievable, it’s downright dangerous.

Time and again, the Government has promised to put GPs at the forefront of health provision - and there is a strong case for this happening whether we like it or not. Much could be done to alleviate pressure on creaking A&E departments by ensuring patients don’t visit them with lesser ailments and choose instead to see their GP.

At present, nine out of ten patient contacts are made with GPs. Given that surgeries are being asked to bear the brunt of patient care, it is frankly remarkable and outrageous that less than 10% of NHS funding is actually devolved to GP practices.

Our ageing population means we are already stretched just meeting demand and with some forecasters claiming the number of people aged over 65 could increase to around 17 million by 2035, how are local practices expected to cope?

The major flaw in Cameron’s plan was, in fact, highlighted in a Government report during the last parliament ‘Securing the Future GP Workforce’. Penned during his first term as Prime Minister it concluded: ‘There is a GP workforce crisis that must be addressed immediately […this] is being compounded by increasing numbers of trained GPs leaving the workforce’ and that ‘evidence is also emerging from the NHS information centre that the GP workforce is now shrinking rather than growing’. This must be seen as a failure of both the Tory-Lib Dem Coalition and this Tory Government.

The family doctor was once seen as a profession respected and valued in our society and communities, however, a recent BBC Inside Out study showed that medical students are shunning the role with around 20% believing that it simply didn’t have a good enough standing and 19% thinking the hours were too long. That same survey revealed that a quarter of current family doctors were determined to leave the profession before they turned 60 in the next few years.

Put simply, low morale and the lure of other professions - and in many cases medical posts abroad - has left us with a dearth of GPs, a problem that token publicity and recruitment campaigns will not solve. The latest of these saw Health Secretary Jeremy Hunt promise to train an extra 5,000 GPs to staff this seven-day service. Given that it takes five years to put a student through medical school and more years to specialise, that process should have started by now and it has not.

Greater Manchester has been set up as a beacon for Cameron’s seven-day GP appointment dream. Behind Mr Cameron’s rose-tinted glasses pilot schemes have apparently proved to be a success, demonstrating patient satisfaction and value for money. But I know those working in surgeries within GM, had they been asked, would highlight the very real problems that arose with already established appointment systems, out-of-hours provision, walk-in centres and new surgeries, wholly due to the new scheme. Cameron should fund existing services better, as Labour did, instead of attempting to reinvent the wheel for Tory electoral gain. This isn’t about an unachievable 7-day service, this is the Tories challenging our GPs to do much more with much, much less.

This seven day appointment proposal is simply an exercise in re-branding bent on point scoring. Moreover, it’s a smokescreen to cover a complete lack of resource which has led to patient dissatisfaction with appointment times and a doing-down of the family doctor - a profession once vaunted and valued.

Let us invest properly in our healthcare system, its training and skills, and let us value our existing GPs and staff more, those who already care for patients and are proud to serve their NHS, no matter what day of the week it is.

From Dr Zahid Chauhan is a GP in Oldham Labour Councillor in the area. He tweets as @Chauhanzahid

 

 

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Readers' comments (2)

  • Its nice to raise this issue in open,
    1. Firstly it was understood that all practices will provide the weekend access
    2. Since then it has now changed to Several GP practices (like locality) to provide services on weekends
    3. It has changed further and now it is considered at few CCGs to bring in an outside provider like those providing the OOH to deliver the weekend access at one site.

    Third option is already available except that there will be pre-booked appointments.

    Issues;
    1. whether the outside provider will have access to patients records for the pre-booked appointments
    2. will the access be provided at multiple sites
    3. will all practices will be allocated slots for their pre-booked appointments

    I believe it is a high time, the secretary of state of health should change his advisors before making more of such gimmicks, he is simply befooling himself and his party

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  • As an out of hours provider I absolutely agree with this article. We have excellent 7 day access already. Any pilot,vanguard,PCF £££'s invest in your social enterprise Ooh services which already have robust governance and audit embedded!

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