'No U-turn on GPs' hours' insist BMA

The media is reporting that the BMA has 'backed down' or 'done a U-turn' on longer surgery hours. The BMA don't quite see it like that.

'GPs have been put in an impossible position and will have to choose between two unacceptable alternatives,' is how Dr Laurence Buckman, the chair of the BMA's GPs Committee puts it. 'We have been asked which of these two is less bad and we have responded to GP demand that we do that.'

The BMA will be polling the entire profession in mid-February on the plans which could see surgeries open for an extra three hours a week on average, either in the evening or on Saturday. A poll in GP magazine suggests two thirds of doctors will reject the proposal.

'We are not recommending any course of action,' says Buckman, 'and GPs are free to come to their own decision on how to vote. This is neither a climb down nor a U turn but a recognition that between two bad alternatives, one is worse than the other.

'The two deals on the table from the government haven't been negotiated, they are inflexible and do not take into account the differing needs of populations around the UK. It's this method of "negotiation" that has angered GPs and it's why we felt we couldn't accept anything without first consulting the profession. We have been studying the detail of the two impositions and have provided GPs with our analysis. We still have huge concerns that patients will get neither a meaningful service in extended hours nor will the quality be of a level they deserve.

'We believe the impositions as they stand will be unsafe for doctors as they will have to work on their own late at night. Patients also won't get the full range of services.'

As usual, money is key. Health minister Alan Johnson says that the £100m he is proposing will give the typical three-GP practice an extra £12,000 a year for staying open those extra three hours.

However, Johnson's alternative would allow primary care trusts to commission services from other commercial providers, stripping an average of £36,000 away from GP budgets. Buckman says this option will 'harm the underlying fabric of NHS general practice and patient care more quickly and more lastingly.'

Buckman continues to stress that 'GPs are willing to do extended hours, we put forward our own proposal in December.' The sincerity of that proposal has been undermined by the BMA's continued - and mistaken - insistance that the public don't want longer hours.

In a nutshell, don't expect more convenient opening hours any time soon.