Chris Lancelot: GPs cannot squeeze more hours into the day

Time equals money, allegedly. However, unlike money we can't borrow time and pay it back at a future date, or pass the responsibility on to our children (and bearing in mind the economic state of the country, perhaps that's a good thing).

So here we are, stuck with total equality: just 24 hours available in a day for each person, minus time for sleeping and brushing our teeth.

I can't help feeling that this fact is lost on politicians and DoH managers, many of whom behave as though GPs' time was infinitely extensible. Is secondary care overloaded and expensive? Easy - offload the work to the GPs. They can take it on: they've got the time.

You want better diabetic care? Make the GP do it: that's what they're there for. It's the same for asthma, strokes, terminal care, paediatric assessments and PCT committees.

Oh yes, and we should all be spending an hour a week on continuing professional education. Would that be before or after the extended hours surgery?

This ridiculous situation has come about because of the difficulty of defining what constitutes a GP's normal duties. It is all too easy for managers to load extra work onto someone whose job description is nebulous.

Isn't it easy to demand more from others when you don't have to provide the time, the locums or the finances to support the requested actions? Hence the politicians' incompatible requests for improved access at the same time as increasing the length of GPs' appointment slots.

It would be a different story if GPs were paid by the hour. Then the government would be looking to minimise our work and limit our overtime claims.

I can't help feeling that having all GPs directly employed would produce a sea-change in the government's attitude towards us. It would soon curb politicians' and managers' enthusiasm for 'good ideas' if they were faced with an overtime bill.

We all know Parkinson's first law: 'Work expands to fill the time available'. Unfortunately, some managers seem to think that the reverse applies, especially to GPs - that time expands to fill the work available. Sadly, it doesn't.


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