Cameron’s reform to GP services would be dangerous

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I am intrigued that the government is saying that it is going to ensure GP services are supplied by people's normal doctors seven days a week, twelve hours a day, with the over 75s guaranteed access to their own personal doctor, and all that for an annual cost of £50 million.

To put that in context, that's £2,000 a doctor - maybe the cost of upgrading them all to the secure email system they're all supposed to consult on in the future.

Politely, this is nonsense. Now, I admit my expertise in this area is second hand as I am married to a GP, but I have as a result seen the detailed workings of a number of GP practices over the years and have discussed GP services with a wide range of doctors. There are three obvious points to make.

First, the proportion if NHS resources going to GPs is already falling, significantly. It is now less than 9% of all resources when it was over 10%. So the service is already underfunded.

That is compounded by increasing demand. I can remember only fifteen years or so ago when an average of four consultations per patient in a GP's list was normal: now it's over five and still rising. That is an enormous change.

Third, there is a desperate shortage of GPs to work in the existing system, largely because of the considerable demands made, long hours and massive stress.

Now please don't get me wrong: there are fat cat GPs in the existing system who treat the NHS as a market and profit making opportunity and so abuse it. And I am well aware that some GPs seem to think that a full time working week is four days, or that they need a half day off in a five day working week. For these doctors I think their time of using the system is over, and that's to be welcomed. But they're not a majority of GPs. Most already work very long hours and can physically do little more than they do now. Which is precisely why recruiting GPs is very hard indeed: young doctors rightly see little appeal in working in this way.

In that case can what Cameon and Hunt will be offering be delivered? I do not think there is any hope if it.

But more importantly, I think it would be very dangerous to try: pushing healthcare professionals beyond their limits is not a way to deliver safe care.