Is the government trying to break the GP service?

Charging to see a GP has already started. I've seen ads for a service where patients can book telephone consultations with a GP for a fee. Big rail stations also have walk-in GPs for a fee.

I live in a small town with two GP practices. Both practices have branch surgeries in one of the surrounding villages. There used to be three practices, but two merged.

My practice is open until 8pm on two evenings.

There is also a Saturday surgery run by a private company but free. I have heard that this is about to have its hours cut or stopped, because it's underused and costing a fortune.

The senior partner (female in her early 40s) gave up GPing completely a couple of years ago and now works as a locum. She told me that the government wants to stop GPs being partners (ie self employed) and to have more salaried GPs working for big providers, such as Virgin. My guess is that they will then be forced to work on Sundays and other unsociable times, but I can't really see this being an improvement. I bet they'll spend much of their time twiddling their thumbs waiting for emergencies.

I know someone who has recently qualified and become a junior doctor.
He personally has never liked to work over hard. He has not yet decided which branch to specialise in[I dont think he has to for his first two years]?

The only 2 branches he has definitely ruled out so far are being a surgeon, and being a GP. He doesnt want all the hard work that those two particluar branches involve.

Maybe we should point out to JH that GPs are human beings not automatons. They have partners, children and family responsibilities just like the rest of us. Not only that they have to be able to make life and death decisions with regard to some of their patients. Do we really want GPs who are exhausted after working 12 hours to be put in the position of deciding whether a patient has a very bad case of indigestion or a silent heart attack?

Walk in centres are already open from 8am to 8pm and a lot of practices use out of hours locum arrangements so it is possible to see a doctor 24/7. You may have to wait at a walk in centre but then you'd be waiting at a and e.

If the surgeries are open longer hours then all the running costs will increase proportionately.

I know some people have to wait a long time for appointments but that's not the fault of the GPs. It's the fault of governments (not just this one) who have constantly demanded more and more from the GPs until it is no longer attractive to young doctors. Also practices have been closed down as they didn't have enough patients (even though they had thousands)so those patients had to be shared by the remaining practices. Like everything else in the NHS it comes down to money. This government would like the system to collapse so they can allow private companies to take over this part of the NHS and charge to see a GP. Another nail in the NHS's coffin.

There's a shortage of GPs everywhere. I know it's hard to recruit where I live in London due to high housing costs and the added difficulties of an area with a population with a majority of immigrants so often a language barrier. GPs already work long hours. They can't open longer unless more doctors are trained, which is a long process. It will only get worse when we come out of the EU and no longer have European doctors available to come here.

It may seem hard but babies are very transportable. A doctor can often see six patients in a surgery compared to one home visit. Medicine has become more and more complicated and a lot of conditions that previously went untreated are now being treated eg chronic kidney disease, early diabetes. Time for this has to be found from somewhere. Over my thirty years in General Practice workload increased year on year. In the early days I used to do about five visits a day. However a lot of those were not really necessary to be done at home and not a good use of an expensive resource. I did enjoy home visits though!

mumofmadboys,we live in a small town there are several GP practices and around 6 dental practices ,if I want to see a doctor I need to take time off work ...if I need a dentist they are open from 7.30am until 7pm and have one late night,a different one in each surgery.Now to ME that seems sensible it saves people losing wages because of daytime only appointments.When I was young ...I'm 62 ,the pGP practice I'm still with had only 6 doctors and yet they did home visits and night visits in emergencies,now if you have a sick baby you're expected to drive over 20 miles to the nearest A and E that is not progress.

Same here, rosesarered. Our GP surgery,- which is a huge one, is only open 5 days a week and closes early evenings. And trying to get an appointment is increasingly difficut.We are lucky if we get a phone call back within a week. They need to pull their socks up a bit. They should absolutely have to open on Saturdays, at least. And it certainly does mean that more people go to A&E instead.

annie I'm talking about the women on R4. They are just as terrier like but do it without the accompanied hysteria

Our surgery shut for one afternoon a month. It happened in all the surgeries throughout the town I worked in. That half day was covered by the out of hours provider and two GPs covered it. This enabled all the GPs to get together for training for 3-4 hours. It was always useful and helped us keep up to date.

Humphries never has been a nodding dog interviewer , heaven help political interviews when they all become Victoria Derbyshires and sit with sympathetic noddings of the head

JH is getting a tad out of control imo with whoever he interviews - no bias meant here. The women are imo much better.

Thank you for that insight, MOMB.

I heard John Humphrey this morning savaging a GP spokesman whom he was battering with, among other things, the question of some surgeries being closed for half a day a week. (It was the most ill mannered I have ever hear JH but that is a side issue). Surgeries may be closed for patient appointments for half a day a week, but that doesn't mean they are closed for that half day. They are for other clinics and, ours being a teaching practice, I presume for training students, which are often in attendance. I have had instances where doctors at my surgery have contacted me with information at gone seven o'clock and in one instance eight forty five in the evening so they obviously don't go home at five o'clock and forget it.

Straight from the horses mouth -

I am a retired GP. There are many problems covering 8 am to 8 pm seven days a week . There would not be a nursing team covering those hours. Receptionists would be spread thinner and you always need two on duty even in small practices. The GP partners would struggle to meet together to plan and sort out problems within the practice. GPs would be thinner spread over the 84 hour week and there would be less support for GPs wanting a second opinion from a colleague or support in difficult/ emotional cases. Being a GP can be a lonely unsupported existence.General Practice will become even less appealing to junior doctors. Different hours each week will lead to problems with arranging childcare. We opened one evening a week till 8 pm but sometimes had problems filling these slots.

That is a very good question JessM and I fear whitewave is right as well, the government seems to be set on breaking the NHS.

The demographic can't be a surprise to government, an ageing population is bound to put a strain on health and social care. I can't remember the correct figure but it's something like £4million taken from social care budgets, which weren't big enough before these cuts. Attempts to constructively link social care- health budgets have been underway for years, yet we still have the ridiculous situation of competition between different budgets to meet the needs of the same group. Of course vulnerable elderly people will 'block beds' if the social care budget that should help them leave hospital has been slashed.

I genuinely don't understand the emphasis on 24 hour, 7 day a week GP service. My practice offers an excellent replacement when the surgery is closed. Sadly, the GP's who were young when I was a new patient are now gradually retiring and there are difficulties in replacing them. My area has always been attractive to young doctors because school s are good and housing isn't ridiculously over priced. it's a teaching practice with a good reputation. Yet, it's struggling to replace GP's as they retire.

If Theresa May/Hunt were to announce a small increase in taxes, to be used only for the NHS I suspect very few people would object. Alongside that, this government needs to stop attacking public servants, all of them but particularly our doctors and nurses. Vilifying folk who dedicate their working lives to others and face stressful working conditions is getting out of hand imo.

Of course it would take some pressure off A&E !

Where I live ( and am sure everywhere) we would welcome the surgery being open on Saturday, or even running a longer service during the day, they close early every evening.

They are trying to break the NHS imo