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Extended hours – GP leader responds to Government’s letter to GPs

February 2008

On 4th February 2008, the Health Secretary, Alan Johnson, issued a letter to all GPs in England outlining the Government’s proposed changes to the GP contract in 2008 and a subsequent threat that the changes will be imposed on GPs if they do not accept the offer.

Dr Laurence Buckman, Chairman of the BMA’s GPs Committee, outlines the BMA’s significant concerns about the Government’s proposed changes in a four minute BMA podcast and webcast that can be accessed via the links to the right of this page.

Responding directly to Alan Johnson’s letter, Dr Buckman said in a statement:
“GPs are not against working extended hours - the BMA's proposals included this as well as significant improvements in clinical care. Indeed the charities which represent older people have said publicly how disappointed they are that the government chose not to accept this offer saying it “would have constituted one of the most beneficial and cost effective reforms in preventative patient care for older people in recent years.” (see note 1) Instead the QOF (Quality and Outcomes Framework) points (see note 2) we wanted to reinvest to improve clinical care are being used to fund extended opening hours – something the government’s own patient survey has shown is wanted by only a minority of patients.(see note 3)

“The 1.5% increase in investment talked about by Mr Johnson refers to a future, as yet undecided pay award from the body that recommends doctors’ pay awards. There have been two years of 0% increases in practice funding and the government’s imposition would see practices lose an average of £36,000 in resources. This is money, taken from the QOF, and given to Primary Care Trusts to use to fund extended hours – yet in some areas there is little demand for this.

“Despite what the government claims, their plans and the resulting loss in practice resources will destabilise many well-established GP surgeries and this could have a knock-on effect on daytime services, the time when our highest users - mothers with young children, older patients and those with chronic conditions - need and want to see their GP. GPs want to provide the best possible care they can because what is good for their patient is invariably good for the practice.

“GPs are worried about the future for their practices and their patients. We are being contacted all the time by GPs who are angry and upset about the bullying behaviour of the government and who fear that the government’s plans will damage general practice in this country. How else can one interpret the threat to take money away from GPs when we know Primary Care Trusts have been told to spend money on private general practice provision by big companies?

“It is because of that strength of feeling that we decided to conduct an opinion poll of the nation’s family doctors. The BMA never rejected the government’s offer, but we couldn’t accept it on behalf of the profession without making certain that we are representing what they think.”

Listen or watch a selection of BMA representatives speaking to the media about Alan Johnson’s letter;
Dr Richard Vautrey, Radio Five Live (7.03am):
http://www.bbc.co.uk/fivelive/programmes/

Dr Richard Vautrey, Channel Four Evening News:
http://www.channel4.com/news/articles/science_technology/row+over+gp+hours/1481147

Dr Khalish Chand, speaking to the Daily Telegraph:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/02/05/ntreat105.xml

View a selection of the newspaper coverage on the BMA’s response to Alan Johnson’s letter;
The Telegraph
http://www.telegraph.co.uk/opinion/main.jhtml?xml=/opinion/2008/02/05/do0503.xml
The Guardian
http://www.guardian.co.uk/society/2008/feb/05/nhs.health
The Independent
http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/doctors-are-being-bullied-over-hours-says-bma-778065.htm
The Herald
http://www.theherald.co.uk/news/news/display.var.2015488.0.GPs_claim_gun_to_our_heads_over_opening.php
Birmingham Post
http://icbirmingham.icnetwork.co.uk/birminghampost/news/2008/02/04/one-size-fits-all-plan-may-spark-staffing-crisis-gps-65233-20433240/
Channel Four News
http://www.channel4.com/news/articles/society/health/johnson+writes+to+gps+over+ops+row/1474062

BMA representatives also appeared on the following radio and TV stations during Monday, 4 February. This is a selection and not the full list of appearances:
Laurence Buckman: BBC Radio 4 ‘Today programme’ / BBC 1 Breakfast News / ITN/BBC News 24
Richard Vautrey: GMTV / BBC Radio 4 ‘Today programme’ / BBC Radio 5 Live / IRN / BBC 1 ‘1 o’clock News’/ Radio Aire/ Ch4 News
Chaand Nagpaul: BBC 1 Breakfast News
Bob Morley: BBC Radio West Midlands/ BBC WM TV
John Canning: BBC Radio Tees / Tyne Tees TV
Roger Bulley: BBC Radio Somerset Sound
Fay Wilson: BBC Radio West Midlands / BRMB (Birmingham Radio)
Brian Balmer: BBC Radio Essex
Paul Roblin: BBC Radio Oxford
Nigel Watson: Wave FM
Beth McCarron-Nash: BBC Radio Devon
Peter Holden: BBC Radio Sheffield
Prit Buttar: Fox FM/ BBC News 24
Kailash Chand: Channel M / ITV Lunchtime News
Grant Ingrams: BBC Coventry & Warwickshire
Tom Frewin: BBC Radio Bristol

Alan Johnson grilled by MPs on the QOF, Tuesday 5 February
Scroll down to John Austin: http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080205/debtext/80205-0002.htm#column_778
Scroll down to Andrew Lansley: http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080205/debtext/80205-0003.htm#column_784


Notes
1. Letter to The Times, 14th January 2008, signed by the President of the British Society for Rheumatology, the President of the Royal College of Nursing, the President of the British Orthopaedic Association, the Director General of Help the Aged, the Chief Executive of the British Geriatrics Society, the President of the Royal College of Surgeons of England and the Chief Executive of the National Osteoporosis Society.

2. The Quality and Outcomes Framework was introduced in April 2004 as part of the new national GP contract. It rewards GPs for implementing good practice in their surgeries. There are currently up to 1000 points available, which can make up a total of 40% of practice income. Every year an expert panel, the BMA’s GP Committee and NHS Employers negotiators seek to define where points may be moved or recycled and what new clinical work or adjustments should be made to ensure patients continue to receive the best and most up-to-date evidence-based care.

3. The government’s GP Patient Survey showed 84% of patients are happy with current opening hours. Only four in every hundred patients wanted extended opening hours in the evening and seven out of every hundred patients wanted Saturday surgeries. Over two million people were surveyed by the government at a cost to the taxpayer of more than £11 million.