David Cameron’s seven-day opening scheme for GPs sounds like an excellent idea for patients, but I’m not convinced it is. I’d be lying if I said that I wanted to work weekends, but that is genuinely not my concern here — though it will be for many people who make up the bedrock of general practice. My concern is how we can possibly make it happen. General practice is currently on its knees. We are facing increasing demand from both patients and the government, and a steadily decreasing income which has resulted in practice closures and mergers. To top it off, we are in the middle of a recruitment crisis which has resulted in many practices being understaffed. Many older GPs are taking early retirement from a profession completely transformed from the one they joined, and many younger GPs are emigrating. Remove a major selling point of the career – flexibility and work-life balance – and we have a really serious problem.
Who will do the work? GPs cannot work seven days a week, so weekday availability and continuity of care will be compromised, and ultimately patients will suffer. The concept already seems to be failing; Pulse magazine recently reported that five months into the government’s £50 million one-year pilot scheme of seven day opening, five of the seven areas who signed up have yet to implement it.
The answer? We must allow more GP’s to see more patients. This means less box-ticking. It also means ensuring the public are educated about health resources (many things can wait until after the weekend or can be dealt with using out-of-hours GPs, walk-in centres and pharmacies). We should also focus on improving secondary care resources: many hospitals still have limited weekend service, and people can wait months for urgent specialist investigation. If we can figure out these issues, then maybe we can think about the weekends.
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