July 10, 2008

Government ‘Bullied GPs into Offering Extra Hours’

I am a full-time GP, a mother of two teenage boys and, like all of us, a potential patient.

Since July 1 our practice, along with many others, has offered extended hours access to our patients. This follows on from a widely publicised push by the Government for GPs to provide access to routine appointments between 8am and 8pm on weekdays and on Saturday mornings.

Until recently GPs were contractually obliged to provide health cover to their patients 24 hours a day, 365 days per year.

But this workload became so heavy that recruitment into general practice started to become a serious problem. Eventually the profession renegotiated its contract with the Government so doctors were no longer obliged to provide 24-hour cover. Although paperwork meant we often worked longer, we were contracted to work from 8.30am to 6.30pm, then go home to our families.

In Devon, excellent organisation Devon Doctors provided medical care from 6pm to 8am and at weekends. These doctors are a mixture of local GPs, doctors waiting for permanent posts, or freelances.

The Government has, in effect, bullied GPs into offering the extended hours. If we do not agree to work the extra hours a significant amount of previously negotiated pay will be withheld from each practice. Some practices have calculated that by the time they have paid their staff, and possibly employed locum GP help to cover the extra hours, it is simply not going to be cost effective to keep surgeries open for longer.

There is little need for this extra provision and that the consequences will be detrimental to the family lives of doctors, their staff and ultimately to society. Most GP consultations are with retired people with long-term problems or with younger people with more minor illnesses. The former can attend at any time, the latter usually need to take some time off to get better anyway.

My share of my practice's extended hours commitment is to work from 8.30am to 8pm every second Tuesday. The extra surgery is after 6pm. I pride myself on having a good relationship with my patients and doing my best to empower them to take control of their own health problems, but there is a limit to how long any professional can listen and will not have either their highest energy or sympathy levels by 7.30pm.

Like most GPs I have children at home and the evening is a valuable time to spend with them. Our staff all have family commitments and would prefer to be at home.

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