GP’s working hours could come back into debate once again in the House of Commons if the Conservatives get elected at the general election later this year. Shadow Health Spokesman, Andrew Lansley has said this week that the Conservative party will look to change rules brought in six years ago which meant GPs were no longer in control of out of hours care. It meant that Primary Care Trusts were given the responsibility instead and often brought in private companies to run the service, because 90 percent of GP’s decided to opt for a pay cut rather than work longer hours when given the choice back in 2004. But after the high profile case when German doctor Daniel Ubani gave a 70-year-old man too much diamorphine, later leading to his death, the Conservatives are looking to change this back to ensure that mistakes like this do not happen again. Lansley said, “When Labour took responsibility for out-of-hours care away from GPs they made a serious error.”


However, giving the decision back to GP’s might not be a solution to the problem of providing the out of hours care that is used by nine million people in the UK every year. The British Medical Association is expected to oppose this proposal, bringing back previous arguments that GP’s were overworked and underpaid. Either way, this is a problematic situation and these cases where people have died will have done nothing to help the NHS’ reputation. People who are concerned about the quality of care may take out a quote for private medical insurance which will provide them with more affordable access to private health care as an alternative.

GPs are under pressure to provide more flexible hours under Sir Ara Darzi’s review of the NHS.

Alan Johnson, the Health Secretary, has expressed concern over current nine-to-five opening hours, saying they are an ‘anomaly’, according to the BBC (10^th Sept 2007).

The Government is not asking doctors to be on call all through the night but do want to see extended opening times to help the millions of people who work during the day.

Mr. Johnson will ask Sir Ara Darzi, who was appointed a health minister in July, to find a solution as part of a nationwide review of health services.

Gordon Brown promised to address the issues of access to GPs on the eve of becoming Prime Minister. He was supported by the Confederation of British Industry, which found that 3.5 million working days were lost last year due to people taking time off to visit their doctor.

The Government negotiated contracts with GPs in 2004. This led to more than 90% of them choosing not to provide out-of-hours care and handing the responsibilities to primary care trusts.

In August, Doctors were warned in a letter from Mark Britnell, the Director of Commissioning at the Department of Health, that unless they open at evenings and on Saturdays, private companies would take over their practices.

But the British Medical Association (BMA) says it would be too expensive to revise a system that many people are happy with. Laurence Buckman, chairman of the BMA’s GPs committee, told The Times newspaper (10^th Sept 2007) that a recent survey showed that at least eight out of ten Britons were happy with current opening hours. He said: “If you open on Saturday mornings – and I don’t think there is any wish among GPs to open on Saturday mornings – they would have to shut some other time.”

Sir Ara Darzi is expected to meet retailers such as Boots and Lloyds Pharmacy to discuss the idea of opening ‘satellite’ NHS surgeries within the chain’s branches. Ministers hope the system could offer patients more flexible hours.

A Boots spokeswoman told The Times (18^th Sept 2007) up to 30 local health authorities and GP practices had expressed interest in a scheme trialed in Poole, Dorset, in which NHS doctors carried out consultations within Boots pharmacies.

Other options, such as allowing patients to register at more than one practice so they can visit a doctor closer to work, have been suggested to the Government in recent years but have been seen as too complex to introduce.

CBI