Dr Kailash Chand: Seven-day GP pledge is unrealistic

Prime minister David Cameron's proposals to provide routine NHS services seven days a week are too crude and pander to a political agenda of wanting to look strong on the NHS and stand tough on patient safety.

How do the politicians who call for a fully functioning 24/7 NHS expect to resource it, when the government can hardly afford its current model and demands are being made to take further billions from the NHS budget in coming years?

Opening GP surgeries 8am to 8pm during the day/evening and at weekends will cost a lot more than the £100m pledged by Mr Cameron - and it's not just doctors and nurses working extra shifts, but receptionists, phlebotomists and so on.

Where are the additional GPs and support staff to deliver this? The £50m pilot project in Greater Manchester is not a resounding success - five out of seven areas have yet to begin.

All efforts should be made to improve services at weekends, in the evenings and out-of-hours, but we should not ignore those already working through the night and at weekends, such as the 40% of GPs who work out-of-hours.

Providing patient care seven days a week and patient safety above all other aims is not possible alongside the coalition government's escalating privatisation of the NHS. An injection of realism is necessary to stop the destruction of the NHS, rather than forcing reform after reform or chasing spurious projects that can only undermine the objectives of this publicly funded body and the morale of its workforce.

The government has spent the past four years pushing NHS changes on reluctant doctors and unwary patients, yet these changes have done nothing to meet the real challenges we face.

Mr Cameron is just fuelling the demand culture and ignoring the available resources, investment required and flexibility needed to achieve his stated goal. For the past two decades, the usual response to problems has not been to try to solve them, but to apportion blame on others, while projecting the image of safeguarding the NHS.

We all want a patient-focused NHS, but it comes at a cost. Unlike supermarkets, which can increase income by making their service more attractive to customers, the NHS cannot attract more revenue by changing its availability to the public. Longer routine work means greater costs - there is only so much to be achieved by efficiency savings.

  • BMA deputy chairman Dr Kailash Chand is writing in a personal capacity.

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