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Last Updated: Monday, 4 February 2008, 13:56 GMT
GPs respond to surgery hours plan
The government wants surgery times to be extended

Health Secretary Alan Johnson is writing to every GP in England urging them to accept the government's plans for extended surgery opening hours.

But the move has angered many doctors, with one telling the BBC it is "gun barrel diplomacy".

Dr TIM KIMBER, from Littlehampton, West Sussex

The government claiming that the BMA doesn't represent doctors is divide and rule, it's nonsense. I sit on the local medical committee in my area, and I see a lot of email traffic about what people are thinking and all GP's are opposed to the government's agenda. What you're seeing is an attack on the profession, and central control freakery.

The government wants to farm it all out to private providers. Every PCT [Primary Care Trust] has been told they have to build a polyclinic, where there will be lots of salaried doctors, but you'll never see the same doctor twice; there will be no continuity of care. I'm looking at my list of patients and I know all of them.

We are all self-employed and we provide a very efficient service. It costs British taxpayers 2 per head, per week, for everything a GP provides, including out of hours services. You're not going to get that from a private provider.

The government has chosen to have this fight. The BMA told the government at the outset that it didn't think extended hours was a good idea, but that if that's what the government wanted, it would provide, and it made a reasonable offer, which the government rejected.

I don't mind being flexible. Instead of having an afternoon surgery today, I could make it an evening one, but that's not allowed. I have to offer my existing hours, plus the additional ones.

These extra GP hours are only going to benefit commuters. The majority of my patients are elderly or children, not people that are working. Now you could argue that that's because they can't get appointments, but that's not the case.

A lot of doctors are worried that if they don't accept this offer, something more draconian will be imposed. We'll be balloted in the next couple of weeks, but it's gun barrel diplomacy, and if we don't stand up now, it'll be the same on every issue.

Dr RUTH LIVINGSTONE, from Stamford, Lincolnshire

There's a danger that if we reject the government's offer, a settlement will be imposed and there'll be a pay freeze. This doesn't just affect doctors, it affects nurses, receptionists, admin staff.

The thing that really annoys me is that the government's own survey showed that the vast majority of people are happy with their GP's opening hours, but they seem inclined not to take any notice. 84% of people said they were happy - very few services get that sort of acclaim.

If doctors vote in favour of longer opening hours, we will move one of our afternoon clinics, which runs from 4pm to 6:30pm, to run from 6:30pm, to 8:30pm. We'll have to have a receptionist on duty, I don't know about the nurses, they all have family lives, we'll have to see how high the demand is I suppose. I suspect we'll all be twiddling our thumbs.

There will only be a partial service anyway - you need to see a practice nurse for things like smear tests or blood pressure analysis, and that won't be available in the evenings.

I'm very sympathetic to the argument that commuters find it harder to get an appointment, being one myself, but we are in danger of designing an NHS around a very small - and it is a small - number of fairly fit and healthy adults rather than the people who really need us.

Dr PETER WILLIAMS, from Bakewell, Derbyshire

The problem is that although GPs would like to increase hours, we are being told that we will have to work more to earn the same money and that if we don't we will have even more money taken away! That is not negotiation. No other profession would allow this.

Opening a few more hours is useless when there are no support services (blood taking, X-ray etc) available. Even the government's flagship Choose and Book service stops working at evenings and weekends. What patients need is well-thought-through services sensitive to local needs. Not imposed.

Dr BRIAN KEIGHLEY, from Stirlingshire

As someone who has always opened on Saturday mornings for urgent cases and commuters, I am angered by Mr Bradshaw's disingenuous comments on the BMA's GP Committee. As [prominent north London GP] Chaand Nagpaul said, the BMA were on the cusp of an agreement that would have delivered not only extra hours but also better clinical services in December within existing resources.

This was all torn up by No 10 for political reasons.

Patients have never been able to receive routine care in the evening or at weekends, and emergency care is now the responsibility of health authorities.

If Mr Johnson and Mr Bradshaw believe they will be believed by doctors over the BMA - they are about to be sorely disappointed.

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