Sep 7 2005
Dr Hamish Meldrum, chairman of the BMA's General Practitioners Committee (GPC), commenting on the Government's access announcement, said the Government was failing to tackle the underlying capacity problem behind the current difficulties in booking GP appointments.
"This is trying to fix the problem without sorting out the underlying cause. With a shortage of GPs, an acute shortage in certain areas, there is bound to be a pressure on appointments. We have never said that, in some parts of the country, there was not a problem with GP access. Where we disagreed with the Government was over their particular 48 hour access target because it made the problem worse. It skewed practices towards a system of book on the day appointments.
"Same day or next day appointments are demanded by the Government in their access target for England. If you book on the day, you either have fewer appointments that can be booked ahead or you try to offer more appointments overall. GPs are already working long and intensive hours. It would not be in their interests, or in the interest of patient safety, to ask them to extend those hours even more to build in additional appointments.
"You cannot create significantly more appointments until you solve the capacity problem. In addition to workforce issues, there is a lack of investment in practice premises - if there is no funding to create more space you cannot put in extra doctors or nurses to see more patients".
"How exactly is the Government going to guarantee this? We support measures to assist practices in making best use of finite time but that does not solve the underlying problem.”
On monitoring of present access targets Dr Meldrum said: "It is an open secret that because of the pressures the Government has placed on Primary Care Trusts, the monitoring has sometimes been manipulated by PCTs. The monitoring measures availability of appointments on a given date which may be notified in advance. If you have unrealistic targets in place, people will find ways round them.”
Dr Meldrum added : "The Healthcare Commission said in their report that, although timely access to GPs and dentists is important, the quality of care that patients receive from their GP, dentist or midwife is also crucial and according to patients, it is extremely good.”