Chris Smyth on March 24th reported for The Times: Skimping on GPs ‘is a false economy and puts patients at risk’ – NHSreality agrees with Dr McEvedy at end of this post.
Four in ten patients wait so long to see a GP that they are worried they are putting their health at risk, according to the Royal College of General Practitioners, which claims that family doctors are under “severe threat of extinction”.
Maureen Baker, chairwoman of the college, said yesterday that a “toxic mix” of rising workloads and falling budgets was putting patient care at risk. She argued that skimping on GPs was a false economy because more patients would end up in A&E, as she demanded more money to recruit thousands more family doctors.
A ComRes poll of 1,000 patients for the college found that 28 per cent could not get an appointment within a week the last time they tried to book and almost two thirds believed that the number of patients GPs dealt with was a threat to standards of care.
Sir, I agree with Maureen Baker, chairwoman of the Royal College of General Practitioners (RCGP) (“Skimping on GPs is a false economy”, Mar 24). There is a definite correlation between rapid access to a GP and a lowering of admissions to A&E departments.
When our surgery was taken over by Elgar Healthcare of Worcester, the number of GP appointments more than doubled and the surgery extended opening hours from four and a half days to five. This, and daily open-access surgeries in the mornings and doubling the number of GPs on duty at that time, has ensured that admissions to A&E units from its patient group remain the lowest in Worcestershire.
Any patient may attend morning surgery, without an appointment, and be guaranteed to see a GP. This is not the case in many surgeries in nearby towns.
Grey Gables Surgery,
Sir, As a GP I have enjoyed sending many letters to The Times regarding health matters over the years. At the moment I just do not have enough time to write.
Dr Mike Betterton
Sir, I am a GP who took early retirement. Whenever I said that general practice could not survive as it currently runs, the official response was the usual ostrich’s backside. For decades governments have imagined that health is a product like any other, best made available following market principles. If so, this product can also disappear from the market.
Dr Trevor Griffiths
Sir, The Royal College of General Practitioners claims that the lack of GPs is putting patients at risk.
It occurs to me that if GPs worked five days a week instead of four and a half, they would be able to see far more patients.
Sir, The chairwoman of the Royal College of General Practitioners has described the current crisis as being due to lack of investment and shortage of doctors. This is disingenuous. The cause can be traced back to the lavish contract with GPs which Patricia Hewitt, the then Secretary of State, agreed in 2004. Family doctors then went on to limited hours, nominally five days per week. For this they were richly, if not extravagantly, rewarded.
In addition, extra doctors were hired to do duty to cover out-of-hours requirements. Some of them were even flown in from the Continent at tremendous cost.
The president of the RCGP now calls for more money and more doctors. In fact what is required is that the present cohorts of GPs should provide extra duties.
I suggest that every general practitioner in the country should do one evening surgery of two hours each week and should work one Saturday or Sunday, in a rota every month, to provide emergency cover.
This would take much pressure off A&E departments and would
deliver a better service to their patients.
Practice duties during public holidays could be allocated on a rotational basis. This is not going to be too arduous for the doctors but might save general practice — and it would deliver a better service to their patients.
Dr Douglas Bell
It is impossible to go back to the old system. In the intervening time, the workforce has completely changed. When I joined my practice, there were 5 full time GPs, all male, and each took a full share of the 24hr on call. In the intervening 25 years, the practice that I am now in has 3/4 the list size and has 7 doctors, only I am full time, and 5 are female. This offers far more choice to the patients but I doubt any of them would be clamoring to work overnight or on Sundays. We do open on Saturdays and some of us do work for the out of hours service which is provided by local GPs. The contract was devised to sort out a recruitment and retention crisis in Primary Care. I think it likely that reversing it would simply lead to the older GPs that are left retiring en masse and it would be impossible to fill their posts immediately.