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Extended hours “mere electioneering”, say GPs

18 June 2008

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Moves to force practices to open longer are “mere electioneering”, are not in the best interests of patients, undermine continuity of care, are not evidence-based and are being funded at the expense of improvements to clinical care, GPs agreed at last week’s Local Medical Committee (LMC) conference in London.

Dr Georgina Brown from Glasgow LMC, who won an additional motion arguing that longer hours give inadequate consideration to the needs of GPs with families, said: “This is not driven by genuine clinical need but by business and employees.”

She also said this was being funded at the expense of other, more important, areas of patient care, and that when faced with issues of urban poverty, funding extended hours is a “misuse of public money”.

The opinions voiced mirror those of practice managers in the recent MiP opening hours survey, in which nearly 90% of respondents believed extra funding should go to other areas of patient care, including addressing the needs of the elderly and those with chronic illnesses.

However, Dr Helena McKeown, a Wiltshire GP and Chair of the BMA’s Committee on Community Care, had asked delegates to vote against Dr Brown’s motion on the need to consider GPs with families.

“Who are we to say we cannot work later?” She asked. “This gives GPs with families – like myself – a bad name and sends out the wrong message”.

She added that many GPs with families in fact choose to work weekends, as this means their spouses or partners can look after their children while they are at work.

Delegates were also united in “deploring” the position held by the Confederation of British Industry (CBI) on extended hours, and agreed that employment rights should include provision for all employees to take time off to visit their GP.

In response to the CBI’s claim that “limited” GP access was costing the UK more than £1bn in lost productivity, Dr William Beeby from Cleveland said: “How many billions would be lost if they didn’t come to see their GP?”

Dr Peter Holden, a Derbyshire GP and GPC negotiator, said employees should not have to worry that they cannot take time off work to see their doctor. “This is about being a humane employer. I am an employer myself and I do allow time off to see a doctor.”

In a separate motion, delegates voted by a very narrow margin to call on the GPC to consider the possibility of GPs taking back responsibility for commissioning out-of-hours (OOH) services.

Belfast GP Alan Stout won the controversial call by a narrow margin, saying that primary care organisations (PCOs) had “failed to deliver effective services” and that GPs should take responsibility – provided they had adequate funding.

Treharris GP William Harris, however, challenged the statement that PCOs were not delivering in Wales, asking where the evidence was for this.

He said: “The jewel in the crown of the new contract was getting away from the 168-hours-a-week commitment.”

GPC negotiator Nigel Watson said: “There are areas where out of hours has worked well. Though I have to say that in areas where it has been good it is where the GP co-ops have won the contract and PCT interference has been at a minimum.”

Dr Watson added GPs should not become the “providers of last resort” just because PCOs have not been able to commission adequate services.


Your comments: (Terms and conditions apply)

“In the area I work a co-op of GPs ran an OOH service, the patients liked the service and the surgery had very few problems relating to the service. However when it came to renewing the OOH contract the PCT did not support the co-op; of the two providers one was a private company. The co-op is still in existance but struggling financially” – Name withheld, Essex