Cameron promises more flexible GP hours


David Cameron: ''This is about getting services right''

David Cameron says he wants to offer more patients the chance to visit a GP in the evening or at weekends.

Under a scheme to be piloted in nine areas of England, surgeries will be able to bid for funding to open from 8am to 8pm seven days a week.

The prime minister said the £50m project would mean doctors "fit in with work and family life".

Mr Cameron has also denied his plan for a budget surplus in the next Parliament will lead to further spending cuts.

The prime minister said the 2008 banking crisis had brought the UK economy "to the brink" and it would be irresponsible not to put money aside for a "rainy day" when the economy improved.

In other developments on the penultimate day of the Conservative Party's annual conference in Manchester:

  • Mr Cameron said he would welcome Boris Johnson back to Parliament while the Mayor of London has urged the Tories to go "flat out" for victory in 2015.
  • The proposed marriage tax break is "very much a first step" to recognising the institution in the tax system, Mr Cameron said
  • The prime minister said he "understood" Ed Miliband's reaction to an article in the Daily Mail about his father and newspapers and politicians should show "judgement" about press limits
  • Work and Pensions Secretary Iain Duncan Smith outlined plans to force the jobless to attend 9-5 classes at job centres
  • Culture Secretary Maria Miller says a new £10m fund will be set up to mark UK historic events, such as forthcoming anniversaries of the Magna Carta and the Battle of Waterloo

Manchester is already piloting an extended-hours scheme for GPs, with family doctors grouping together to offer extra care, in what is being billed as an attempt to prevent "unnecessary" visits to hospital A&E wards.

'Skype appointments'

The wider scheme will see practices applying for a share of a £50m "Challenge Fund", with surgeries becoming "pioneers" in each of nine regions, starting in 2014/15.

Extended opening hours for GPs. Sounds familiar? It should.

The Labour government encouraged practices to open later in the evening and on weekends - offering them extra money if they did so.

Most GPs gave it a go. But the problem was that in many places there was just not the demand and so the funding was reduced and hours cut.

There are still plenty of surgeries that offer out-of-hours appointments, particularly in large urban areas.

But the truth is that the people who are most likely to make use of the service - those of working age - are the least likely to need a GP.

Whereas, the elderly and children who are the most frequent users tend not to have a problem attending appointments during regular hours.

Mr Cameron is also promising more "flexible access", including email, Skype and telephone consultations for patients who prefer this to face-to-face contact.

He told the BBC: "Many hard working people find it difficult to take time off to get that GP appointment, so having these pilot schemes... is, I think, a very positive step forward.

"It also links to the problems we have seen in our accident and emergency departments because the number of people going to A&E departments is up by four million since the changes to the GP contract that Labour put in in 2004.

"What we need to do is enable the right people with the right ailments, as it were, to either go to a GP or to accident and emergency."

'24/7 society'

Health Secretary Jeremy Hunt said: "We live in a 24/7 society, and we need GPs to find new ways of working so they can offer appointments at times that suit hard-working people."

Jeremy Hunt: "We need to rediscover the ideal of family doctors"

The Royal College of GPs said doctors were keen to do more, but were already struggling with their workload.

"We now need the government to go much further and give general practice its fair share of the NHS budget so that GPs can deliver more care and better access to services for their patients in the community," it said.

But Labour said an extended opening scheme introduced by the last government had been scrapped.

"Under the Tories, hundreds of GP surgeries are shutting their doors earlier," said its health spokesman Andy Burnham.

"Patients are also finding it harder to get appointments, and turning to A&E instead, after he removed Labour's guarantee of an appointment within 48 hours."

In his speech to conference, Mr Hunt also pledged to legislate to give the Care Quality Commission statutory independence from government.

This would end "political meddling" and ensure the interests of patients were always put first, he said.

'No splurge'

The Conservatives say they would continue the coalition's policy of fiscal restraint throughout the next parliament - if they form the next government - with the aim of achieving a budget surplus.

Mr Cameron said this would require tough decisions for the next six or seven years but did not "necessarily mean" there would have to be more cuts on top of those announced up to 2016.

"What it definitely means once those years are over you cannot sort of plan another spending splurge. We are going to have to be responsible in our country for very many, many years into the future."

The government was right to focus on containing spending, he added.

"I don't think you tax your way to a strong recovery and we need to recognise that hard working people need more money in their pockets to spend as they choose."

The prime minister also insisted that the government would find the money to freeze fuel duty until 2015, describing help for motorists as a "real priority".


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  • rate this

    Comment number 233.

    Great - we can expect more wrong diagnoses from overtired doctors.

    I think that there should be a minor accident treatment unit in every town to enable hospitals to deal with real A&E.

    As for Her Majesty's opposition - - they cannot tell their A from their E.

  • rate this

    Comment number 232.

    Our politicians (all parties) vision of the NHS has come to fruition.
    Services, Hospitals, wards, departments, staff and GP's in competition with each other.
    They have the cheek to call it National.

  • rate this

    Comment number 231.

    my surgery starts taking calls at 8:30 and I have to leave for work at 7:30 as i dont drive. Not sure how i am supposed to get to the surgery and go to work? the local walk in centre is always packed to the gills!

  • rate this

    Comment number 230.

    The last government changed the contract for the doctors, effectively almost doubling their pay whilst cutting their contracted hours. Doctors leapt at the chance and who can blame them. The crisis in A&E is a reflection of that stupid contract. Trying to get an appointment at your local surgery because they only operate 8.30-6.30 five days a week is impossible. Total madness caused by Labour!

  • Comment number 229.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 228.

    Truth the whole system of medicine need reform in this country. In the rest of Europe medical care is a more normal job, with large numbers of people covering rather than a few working huge hours for a huge salary.
    The whole thing is ridiculous and this can be most clearly seen in psychiatry where the doctors are mostly medically qualified and study psychology very little.

  • rate this

    Comment number 227.

    ioioos said: 'How about halving your salary and doubling the amount of doctors?

    Amazing fact why don't you extend a 50 percent pay cut to all government workers. That way we could have double the police force!, and double Nurses!!, All this time, it was so simple to solve the shortage, because people will apparently work for whatever pay you offer them and not go elsewhere!

  • rate this

    Comment number 226.

    Yesterday was about demonising the unemployed. Today is about pillorying public servants for not working 12x7.

    Extended GP opening hours is a complete red herring. I can't remember the last time I had a problem that couldn't wait a couple of days. If I had had then A&E or a walk in centre would have picked it up.

    Like weekly bin collections this playing to a demand that does not exist.

  • rate this

    Comment number 225.

    This makes some sense and might take some of the pressure of A& E Depts, but as always, the devil will be in the detail.

  • rate this

    Comment number 224.

    Talk about bribe the voters, Osborne will need a very big bugdet surplus to fund all these proposals and no doubt the others yet to come.

    The austerity plan cannot work when money is just being diverted by cutting benefits and servises and the spending those savings on vote capturing schemes. Osbourne I have new for you, get real as there will be no budget surplus and no turn around.

  • rate this

    Comment number 223.

    My GP has always provided completely adequate appointments.

    What I do miss is the availablity of good nursing advice provided by NHS Direct. I wouldn't trust a sick cat to the replacement service, much less my small son, so that is when I turn to A&E.

  • rate this

    Comment number 222.

    David Cameron wants more patients to see GPs?
    Scrap the reforms then! My mum is already working many extra hours more than she is paid to as a salary GP. Not seeing patients but doing bureaucracy that arises from the nanny state and cuts.
    GPs running the NHS= you will wait even longer for an appointment.

    Let GPs do less of the other stuff and more of what patients expect of them

  • rate this

    Comment number 221.

    The issue I have - I have a medical problem. it means I need to see a GP every few months, just for a check-up. I work. Because my GP is only available during working hours, to see my GP I have to take a day off work. Great extend hours - but I get fed up of spending 20 minutes telling a new doctor what is written in my notes and what my GP already knows!

  • rate this

    Comment number 220.

    So if GP's are not prepared to offer 'service excellence' and reach beyond expectation like every hard worker employed in this country has to, then slash their funds, make them work on an on-target miserly commission only basis or sack them and expand the A&E departments massively with triage nurses sifting the emergencies from the non-emergency.

  • rate this

    Comment number 219.

    As Cameron has said the GE isn't for another 18 months. So why all these promises and political gimmicks. If these two (Labour and Conservative) really think we are still going to fall for all this false rhetoric then they have another think coming.

  • rate this

    Comment number 218.

    Yes, a good policy, access needs to be more flexible.

    I wonder if a similar exercise be undertaken for politicians and their 3 month summer sabbatical. They often give the excuse that parliamentary time is at a premium, well how about actually being there a bit more then.

  • rate this

    Comment number 217.

    This is missing the point completely. Where is the discussion about the patient's responsibility to take the best care for themselves? If we subtracted the self-inflicted illnesses of smokers, drinkers and over eaters from the workload on the NHS there would be plenty of surplus capacity. Needless demand has outstripped provision.

  • rate this

    Comment number 216.

    You people do realise that all this has to be funded? No one is going to work an extra 2 hours a day plus weekends for free? (would you??). That's doctors, receptionists, phlebotomists, radiographers...

    Enjoy the early retirement of many existing GPs, the influx of GPs from abroad to replace them and those GPs who will leave England for better paid work away. Gps don't have to work for the NHS.

  • rate this

    Comment number 215.

    For the record GPs aren't paid '£100,000 all their lives', there is the small matter of getting a medical degree, and specialty training, taking on average 10-11 years. The £100,000 is also only earnt by GP's who work about 11 hours a day, 5-6 days a week (only earn that much by doing extra hours usually), many do not earn this. They're well paid, but don't ignore the facts, or tuition fees

  • rate this

    Comment number 214.

    My GP in West London is paid over £160k a year & might even exceed over £200k. The practice has 8 GP's.

    They're open Mon-Fri 08:30-18:30 and closed over the weekend.

    Or are they?? On Saturdays they're open for Private Patients ONLY!

    People get sick 7 days a week. They should be forced to spread their budget over 7 days, by hiring more GP's to create a weekend rota and home visit team.


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