Question 10 of the ‘discredited’ patient access survey gives patients carte blanche to say they would like GP surgeries to open late in the evening and at weekends (GP, 1 December 2006).
What patients would like is a panacea, and whether such a service is an essential, affordable, rational or sensible use of resources should be seriously considered.
Primary care organisations have arranged for out-of-hours services, funded by our out-of-hours payments, to deliver appropriate out-of-hours care in the form of NHS Direct, doctor/nurse triage and primary care emergency centres, with home-visiting doctors if necessary.
This has enabled a more rational use of medical resources and fostered better self-management of minor conditions by patients, with major emergencies still being handled as normal.
Any move towards fragmenting the service again, with each GP practice being open, staffed by GPs, practice nurses and receptionists, is not a cost-effective use of resources and is a backward step in moves to enable patients safely to self-manage minor, self-limiting problems. What is more, if we have to move resources to cover the evenings, daytime access will suffer.
In a society where we cannot afford anti-cancer and anti-dementia drugs, it seems crazy that the government is contemplating spending money on pandering to some patients’ whim of having their local surgery open all hours of the day and at weekends, supermarket style.
Question 11 of the survey ought to be ‘Would you be prepared to pay more tax to fund your surgery being open at the weekends and evenings?’
GPs have homes to go to, families and lives to lead, just like MPs and patients, and we work hard enough already.
Dr Anthony DeWeever