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Brown’s last stand on access

Phil is incensed by the Prime Minister's desperate promise to further extend GP hours

?I'm writing this on the day of the final Prime Minister's Question Time of this shameful failure of a Parliament, and I've just heard Gordon Brown state, among a string of other frantic promises amid the jeering of an out-of-control House, that should Labour be improbably re-elected once again, everyone will be able to see their GP in the evenings and at weekends. This was an unequivocal promise. He's going to deliver it, if we vote him back in.

I'm not sure how to interpret this. Was it the panicky jibbering of a desperate man peering into the electoral abyss? Or did he actually mean it? And if he did mean it, was he using his famously convoluted syntax to convey that we can all see a GP out of hours (which we all already can, in theory)? Or did he seriously mean you will be able to see your own GP, and our already extended hours can be extended further, to 70-odd hours a week, and he's going to make it compulsory? Either way, the man is a knob.

We've been here before, but let's look again at extended hours. I spent three Pulse columns railing against the pointlessness of the venture and trying to get you all to say: ‘No – thus far and no further.' It didn't work. To the shame of the profession, most of us caved in and are doing it. To my shame, I'm one of them. In my defence, I'm only doing it because I was outvoted by my partners, but the fact remains, one or two mornings a week, I'm schlepping up to this bloody place at 7.30am, with hell in my soul.

These 6am alarms are somewhat fraught. Who knew that Sarah Kennedy had a show on Radio 2? Not me, but these days I count myself as one of her regulars (my brain is not ready for John Humphrys at that hour).

When I arrive at the practice (recently, after ploughing a lonely furrow through virgin snow) I'm greeted by staff members bearing not one but two cups of coffee.

Then, bleary-eyed, I'm consulting. And I'm faced with EXACTLY THE SAME familiar punters who can and do attend at any other time. And I'm reproached for it! ‘Why have I got to come in this early?' they say. ‘You don't,' I reply. ‘But it was either this or I had to wait until Monday to see you!'

The whole point of extended hours was that people who could not see their GP in the day because of work commitments could have an appointment outside work hours, and I've been keeping tabs on it. I ask them. And in six months just ONE patient has made an appointment for this reason.

It's a pointless charade. I don't want it, the patients don't want it, and it's going to make bugger-all difference to our access scores because in our last survey, only 2% of patients expressed any interest in us extending our hours at all, and I doubt any one of those seven or eight punters has used these early appointments even once.

Let's face it – Gordon Brown hates GPs and has done his sly best to damage the profession. Maybe he can't bear that people like us and distrust him – who knows? But without any doubt he's indulging in one last, flailing, venomous stab at us before the power is removed from him forever. Let's do our best to make sure this is so.

I'd better go to bed now. I've got to be up in five hours' time.

Dr Phil Peverley is a GP in Sunderland