Chris Lancelot on ... Extended opening hours

I wonder if Gordon Brown realises the damage he will do by insisting that GP practices stay open late and at weekends?

Surveys consistently show that only a minority of patients want this; three quarters of the population are happy with the current opening hours.

Late opening will undoubtedly help commuters, and I have every sympathy for those in this situation. However, our own experience with commuter surgeries is not good. We used to run them, but uptake was extremely limited and they were soon shut down for lack of demand.

By asking us to stay open until 8pm the prime minister risks reducing, rather than improving, access to primary care. There will be no increase in surgery time. GPs will just move their surgeries around. Many will start their evening surgery at 6pm rather than 4pm, or else work a shift pattern, dropping the morning surgery that day.

The net result will be fewer daytime appointments. Yet senior citizens won't want to attend in the evening, with all the risks of falling, travelling in the dark and being mugged. Young mothers wishing to come on their own will be inconvenienced because the creches will be shut. Children will have to be kept out of bed in order to attend.

Increased pressure on daytime appointments will mean many patients waiting longer to be seen because an evening appointment would simply not be appropriate. No wonder the majority of patients want opening hours to stay as they are.

The prime minister should listen to what patients and professionals are saying. Practices should be asked to open late only where there is a clearly established demand. A Saturday-morning surgery would satisfy most commuters, perhaps with the occasional weekday late opening. This is all that is needed for full care of chronic illness, and if commuters are acutely and seriously ill they won't be commuting.

Extended opening will cause increased stress on the family lives of doctors, nurses and reception staff, especially in the smaller practices where there are fewer colleagues to share the burden. It will be the last straw for many older GPs, who will retire early as a result.

By insisting on extended opening Gordon Brown is forcing primary care to inconvenience almost everyone - patients and staff alike. He is about to achieve a spectacular own goal. Will this government ever listen? Will it ever learn?

Dr Lancelot is a GP from Lancashire. Email him at GPcolumnists@haymarket.com.

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