Now it’s even access to GPs which is a problem in the “National Hell Service”…. denial and unreality continue. Less and less is National about OUR health services..

Unlimited demand, (Patients set to book 10m GP appointments online this year) limited resources (NHS urges people to book GP appointments online), and no disincentive to make a claim  (Comprehensive spending review and the NHS) result in the post below. Now it’s even access to GPs which is a problem in the “National Hell Service”…. denial and unreality continue. There’s no pain for missing an appointment either: (61k patients a day miss their GP appointment … – Mail Online). Less and less is National about OUR health services..: (Patient has to make 99 phone calls to a GP surgery before she is finally given an appointment)


Over a quarter of us struggle to get doctor’s appointments, reported in the Mail, 26th November 2015. In the Times 27th November 2015 Kat Lay reported: Making appointments with GP is harder, say patients. (not on line) and in Tenby it’s become a crisis: Problems getting GP appointments in Pembrokeshire raised at CHC and health board… Sofia Lind in Pulse 27th November reports: GP practices to reduce routine appointments on junior doctor strike days.   

Gillian Bowditch in The Sunday Times Scotland reports 9th August 2015: National hell service? and Alice Thompson opined: GPs must think big to cope with strain that won’t let up.

Pay us per patient if you want ‘Martini’ GPs – The Times letters 1st October 2014 are worth re-reading! But the answer is rationing by co-payments…

Sir, I believe that the current crisis over the lack of availability of GP appointments is easily remedied: pay GPs a proportion of their income on a per-consultation basis, at least at weekends “Cameron tells GPs to work at weekends”, Sept 30). The more work undertaken, the greater the practice income. Should remuneration be adequate, demand and supply may match, just like any other business.

This is how Australia makes it work. Efficient and productive GPs earn more, and many British GPs and specialists are emigrating for precisely this reason. We, meanwhile, plug the gaps with doctors trained in second and third-world countries, who would be in Australia if they met the entry requirements. Britain’s problem is compounded as there may be a reluctance for GPs to work much harder or longer because at above £100,000 a year our tax rates are punitive; and with the ever-rising costs of medical indemnity it is not worth undertaking what is effectively overtime for perhaps £15 per hour net. Most of us would rather have the time off. Show me the money and I’ll work anytime, anyplace, anywhere.
Dr Alexander Barber
Camberley, Surrey

Sir, The Conservatives’ plan is intended to enable patients to find it easier to see a GP. Doctors, however, will instead interpret it to mean an occasional longer day on a rota basis, offering the same number of appointments as now. Patients will be no better off, and may just find themselves as frustrated as they do today. What is needed is a contractual appointment rate — perhaps the number of standardised (ten-minute) GP appointments per 1,000 registered patients per week, together with publication of each individual surgery’s performance.
Dr Stephen Humphreys
Welwyn, Herts

Sir, The funding for seven-days-a-week GPs will be paid from existing budgets. At my surgery we have started to politely refuse requests to take on new unfunded projects such as this initiative. We are ensuring that we do not burn out and can continue to cope with the ever-increasing workload. It would be much better for David Cameron to sort out the duplication of out-of-hours care, the 111 phone number, and minor injuries units to create a streamlined weekend service.
Dr Stephen Brown
Beaconsfield, Bucks

Sir, Mr Cameron’s proposal would require more than a doubling of GPs’ workload. It implies an increase in annual GP salary costs of £3 billion a year — excluding additional support staff costs. I believe that many doctors will simply press the early retirement button. Is it really necessary to be able to take someone’s blood pressure on a Sunday?
Martin Hamer
Burbage, Wilts

Sir, Yet again GPs are being used as a political football. One issue to be considered is the incompatibility of increased opening and the viability of small practices. Are patients prepared to see the end of their “local” practice as the price for increased GP access? As a recently retired rural GP, I believe that most patients here would find larger (but more distant) providers of GP services too high a price to pay.
Dr John Harris-Hall
Knapton, Norfolk

Sir, I should imagine that those GPs working evening shifts will be the single, older and childless. Some GPs have families too, and might not be keen to sacrifice seeing their own family in order to facilitate others seeing theirs.
Dr Larry Amure
Over, Cambs

Sir, The proposal to provide 24-hour care by GPs is not new. My contract 20 years ago demanded that I provide care for my patients 24 hours a day, seven days a week. Time off was organised with colleagues to cover each others’ practices. In my case I was on call one in four nights and one in every four weekends. One never felt overworked unless there might be an epidemic. I even had time to play golf and with loci assistance take holidays. However I do not know how Mr Cameron’s plans will
work given the great shortage of doctors. Will he ask we retired GPs back?
Dr Michael Bott
Kirkella, E Riding

One in four patients cannot get through to GP surgery

And there is pressure not to examine the patient: GP appointments by Skype and FaceTime: health bosses reveal future of urgent care in Croydon

Devon goes on line for appointments: No more hanging on the telephone as online booking service unveiled for Devon patients


This entry was posted in A Personal View, Commissioning, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s