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Minister’s A&E comments display shocking ignorance

On BBC Radio 4’s Today Programme on 24 April, the health minister Dr Dan Poulter told listeners: ‘There isn’t the community-based care that there used to be, thanks to the previous Government scrapping the GP out-of-hours system [… Patients] are now sort of being forced to turn up at A&E because they haven’t got a GP to see out of hours.’

Firstly, GP out-of-hours services existed both before and after the 2004 contract, but the difference between 2003 and 2013 was that the Department of Health became responsible for commissioning services from alternative providers, and as a result standards have fallen.

Secondly, let me suggest a few alternatives to Dr Poulter’s frankly inappropriate advice for patients who feel ‘forced to turn up at A&E’: self-management; advice from pharmacists, NHS 111 or NHS Choices; contacting out-of-hours services or visiting a walk-in clinic; or simply waiting until your GP surgery is open.

Dr Poulter is not only a health minister but also a qualified doctor, and yet displays an astounding ignorance. Exposure on national radio gave him an opportunity to add to public education, but instead he used it to take a swipe at political opponents.

I can see why you chose not to work at the sharp end of medicine, Dr Dan.

From Dr David Bush, Wolverhampton


Why can’t people see it is the four-hour target that’s fuelling demand? Patients who want to be seen quickly regardless of the urgency of their problem will always bypass GPs for A&E. The British public needs to decide what they want, and be prepared to pay for it.

From Dr Shaba Nabi, Bristol


The public wants instant access but commissioners want ‘value for money’ – a full working day of health promotion and chronic disease management, plus unlimited ‘instant access’ to the same GP. The name is not Dr Who: GPs cannot be in two places at the same time. That said, workforce expansion and perhaps an unscheduled medically led primary care rapid-response team (working on a rota basis like the hospital acute medical and surgical take system) might help.

From Dr Andrew Mimnagh, Sefton, Merseyside