Anstey Road, AltonHampshire GU34 2QX
Monday - Friday8:00am to 6:30pm
Your GP surgery works hard to ensure that most patients can be seen as soon as possible, and at times that are convenient. We understand that many patients have to work and sometimes may struggle to get an appointment time that fits in with work and other commitments. At present, we are open from 8.00am – 6.30pm Monday to Friday; care outside these hours is provided by Thamesdoc.
Those who need emergency appointments can see a doctor as soon as possible and satisfaction levels with our service is very high. A recent questionnaire confirmed that 86% of our patients say they are happy with current opening hours.
You may have read or heard reports that GPs have refused to extend their opening hours for patients. In fact, the British Medical Association has offered for GPs to work longer hours by limited opening in the morning or evening or on Saturday morning for routine appointments, but our offer has been rejected by Government. It wants us to open for longer times, but we believe that this would reduce our availability to the majority of our patients and harm their care.
We are also fearful that the Government may be using this issue to introduce further reforms, through the back door, that will affect patient care.
There are 250 million consultations with GPs in the UK every year. Most appointments are needed by elderly people, small children and patients with long term conditions. These patients require a high level of service during the day. We believe it is a fundamental value of the NHS that those who need the care most, are most able to access a GP and support services. If surgeries were to stay open for longer, there will be fewer appointments and resources available for these patients.
Although the Government may present their plans as ‘patient friendly’ or responding to ‘consumer’ demand, a GP service is not the same as a supermarket or a bank. We know that for our patients, quality is the most important concern, and that we will not offer our best service if we are continually undermined by reforms that do not offer real benefits to patients.
There is no benefit to patients of a surgery opening for longer if the quality of care is poorer, and the patients who need care most find it harder to get the appointments they need. We are also concerned that extended hours are an excuse for the Government in England to introduce large GP surgeries or polyclinics that may be run by multinationals. GPs are very worried that this will put your local surgeries at risk.
GPs are fighting these reforms, as we do not believe they are right for us or for our patients. Ultimately these reforms could undermine the very basis of the NHS. The NHS is 60 this year, please help us protect it and keep it working for everyone, particularly those who need it most.
We need your support as your GP surgery, as you know it, is under threat. If you value your local surgery and the NHS there are two things you can do:
· Write to the local or national press telling them you are against these changes and why.
· If you have Internet access, please sign the national petition to No 10 Downing Street: http://petitions.pm.gov.uk/Polyclinics
· Write to your MP and tell them how much you value your local surgery, do not want to lose the relationship with your family doctor and do not want to see the breakup of NHS general practice that this government is planning. Depending on where you live, his contact details are:
East Hampshire Hampshire North East
Michael Mates, MP James Arbuthnot, MP
House of Commons, House of Commons,
London SW1A 1AA London SW1A 1AA
Thank you for taking the time to read this letter.
The doctors at The Wilson Practice
The provision of primary care services has always been about a partnership between the doctor and the patient. Nowhere is this more evident than in out of hours or emergency cover.
From the inception of the NHS in l948 GPs were responsible for all the patients on their list 24 hours a day, 365 days a year. Most GPs, particularly in rural areas, ran a personal list system – as we still do. There was a reasonable understanding that the doctor you called at 3 o’clock in the morning was also the same doctor who had worked a full day the previous day and would be working a full day the following day. For those who have never had to work in this sort of system it is sometimes a difficult concept to grasp and the hours we worked were almost incomprehensible. Most full time doctors in the Wilson Practice until four years ago were working over 70 hours per week. Inevitably it was sometimes difficult to give of your best when you were so tired. The situation did not improve as time moved on. Medicine advanced, meaning that doctors were able to do more; patients’ medical expectations have therefore quite correctly increased. We have moved to a much more 24/7 society and people have increased expectations of availability of medical advice and access to doctors at any hour of the day or night. This was set against a rapidly changing medical work force. Over 75% of entrants to general practice are now female and many are part time. Whilst this has redressed the previous imbalance of a male dominated profession many of this newer generation of doctors do not want to do on-call – indeed it is not a possibility for them as they have young families to care for at home. All of these factors meant that the situation and system that had worked for 40 years was no longer tenable.
The new contract introduced by this Government in 2004 addressed amongst other things this problem. It changed things dramatically and I believe for ever. The Government took out of hours responsibility away from GPs and gave it to the PCTs. They clearly thought that this would be a simple and cheap option to run but unsurprisingly this has not proved to be the case. There is no doubt that the Government and Department of Health undervalued the work that GPs were doing out of hours, and now they wish to backtrack. There has been a lot of bad press and propaganda from the government which has been extremely unhelpful. The new contract may have taken out of hours away from us but it also heaped upon us considerably more bureaucracy and day work. Despite losing out of hours we are still working in excess of 50 hours a week and simply going back to the old system is not an option. The current out of hours service needs to be improved, it needs to be made more local and more responsive and there are certainly ways in which this could be done, perhaps by making better use of local facilities such as community hospitals. It requires Government to work with the profession – sadly not something that they have shown a great willingness to do. Meanwhile the partnership between doctors and patients must continue and it is up to all of us to direct Government to make the correct decisions on our behalf to provide not only a good and safe out of hours services but also a day service that is manned by doctors who have not been up all hours of the previous night or expected to be up for most of the following night. Many people believe that this would have been a much more effective use of increased resources than some of the high profile political initiatives such as Choose and Book which has proved, at least in this area, a complete and expensive irrelevance.
Dr Michael Hayward