Now BMA cites dodgy data on GP hours

The BMA have hit back at the government's reported 'more flexible opening hours or else' ultimatum to GPs.

The Times has claimed that a letter has been sent to to local NHS bodies telling them, in the words of the newspaper that 'unless they agree to open at evenings and on Saturdays, private companies will be contracted to take over their practices'. The author is reportedly Mark Britnell, the Director of Commissioning at the Department of Health, England,

In their defence the BMA are citing the recent GP Patient Survey which allegedly showed widespread patient satisfaction with current opening hours.

However, this survey has been highly discredited — not least on this site (Opening hours: Are the NHS asking patients the right questions?). Its methodology and the very limited nature of the response options have been criticised — particularly in comparison with the more methodologically sound Healthcare Commision (HC) survey. The HC survey earlier this year showed that far from being satisfied with opening hours, one in four patients had been put off going to their GP because of the limited opening hours in the previous 12 months.

The BMA is now using the dodgy data of the GP Patient Survey to back up its members' reported reluctance to open more flexibly.

Dr Laurence Buckman, the north London GP who chairs the BMA's GPs Committee, criticised the government for its 'aggressive heavy-handed approach' and for failing to even attempt to talk to GPs about their plans. He said: 'Family doctor practice opening hours are agreed with the government and were established after long and careful negotiations. There are already provisions in place for primary care organisations who want to resource extra opening — very few have made use of these because they are not a good use of resources and because they reduce care for most patients during the day when most of them want to be seen.

'Offering GP services involves more than a doctor sitting in a consulting room — general practice in the 21st century requires an extended primary care team backed up by the diagnostic tests not usually available at evenings and weekends. If the government wants to talk to us, we'll listen, but we don't want to see them force practices to reduce the quality of care they can prove they provide to their patients.'

Recognising GPs often heavy workloads, generous changes were made to GPs' contracts in 2004. In addition to salary enhancements taking pay over the £100,000 mark, the doctors were permitted to opt out of providing night and weekend care. Most doctors — nine in ten - opted out, leaving it to their Primary Care Trusts to employ private firms to provide cover.

'The change has been the subject of mounting controversy, with patients struggling to get through to doctors' out-of-hours and for Saturday surgeries.,' says Nigel Hawkes, The Times health editor.

The MHF supports the campaign for more flexible GP opening hours. Our experience and survey after survey suggests to us that this is what men want.

We are convinced that 9-5 opening is one of the biggest obstacles in the way of men making effective use of primary care services - certainly, without more flexible opening as a starting point, we will be hampered in all other attempts to improve the health of men.

Ideally the wider opening hours would be provided by the GPs themselves not some third party which is unknown to the patient and not an integrated part of the wider NHS.