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Health: GP Surgeries

Volume 707: debated on Monday 9 February 2009


Asked By

To ask Her Majesty’s Government what progress they have made in extending the opening hours of general practices.

My Lords, thanks to the efforts of general practitioners, their staff and primary care trusts, the NHS exceeded our objective of at least half of all GP practices providing extended opening hours by December 2008. Seven out of every 10 practices currently offer extra appointments outside normal working hours. That proportion continues to increase.

My Lords, I thank my noble friend the Minister for that reply. I endorse the fact that GP services are improving—my own service in Brighton is exemplary. However, does he acknowledge that there are some worrying regional variations in the extension of opening hours? Is he concerned that this might lead to greater inequalities in healthcare provision than already exist between deprived and affluent areas?

My Lords, I said that 50 per cent of GP practices are open for longer but in fact 70 per cent across the country are opening longer, and we anticipate that that figure will have improved by March. As for inequalities, the extra £100 million that the Government have invested includes provision for setting up 112 traditional primary care practices to tackle inequalities. That is in addition to our attempts to develop the quality of care provided in deprived areas through improvements in the QOF scores.

My Lords, does the Minister agree that whatever the opening hours for GPs, GP practices should be allowed to be more flexible in the appointments they give, thus allowing patients not to have to make numerous phone calls in order to fit in with the 48-hour target?

My Lords, the recent survey we carried out showed that 87 per cent of the population are happy with their ability to obtain appointments within 48 hours. I could not agree more with the noble Baroness that flexibility is an important part of that. I am delighted to report that nearly 70 per cent of patients can also book the specific general practitioner whom they wish to visit.

My Lords, how are the Government monitoring the incidence of patients who book an appointment but fail to turn up, and fail to ring the practice to inform it that they are not going to turn up? Will the new constitution help in resolving this clear waste of resources?

My Lords, I have no doubt that that information is recorded and measured at a practice level and that many general practitioner colleagues and staff, such as practice managers, are actively recording that information and feeding it back to patients who may, as the noble Lord points out, be abusing the system.

My Lords, are not Saturdays one of the prime times when working families would like to see their doctor? If so, what progress has been made in that direction?

My Lords, that is part of our policy: “extended opening hours” refers not only to evenings but also to Saturday mornings. As I said, a large number of practices—50 per cent to date—are opening on Saturday mornings to meet the needs of the local population.

My Lords, does a doctor have to be present during opening hours, or can a practice nurse supervise the routine running of a practice?

My Lords, all of these health centres will have a general practitioner available from eight in the morning to eight in the evening, seven days a week. As the noble Lord will be fully aware, in addition to a general practitioner, other team members, including nurses, practice managers and others, will be available.

My Lords, what is the current situation regarding visits by general practitioners? When I was involved in running the health service in London there was a major problem in that certain areas were not safe for general practitioners to go to after certain hours. This applied particularly to women practitioners, who often had to take a large dog or a bodyguard with them. In view of all the knife crime in London, is this a continuing problem, or is there now no difficulty?

My Lords, I think that the noble Baroness is referring to out-of-hours home visits by general practitioners. I agree that it was an issue, and it is why 10 regions around the country have considered the acute pathway in designing services around the needs of patients out of hours, possibly including a dedicated telephone number by which a patient can be evaluated and the appropriate expertise sent in an out-of-hours visit to meet the needs of the patient.

My Lords, does the Minister accept that there are general practices where there is no demand by the patients for these extra hours—some country districts, for instance? Will the Government allow them to carry on as they are, or will they all be forced to open?

My Lords, as a medical practitioner like the noble Lord, this is the first time I have heard that patients may not wish to see doctors being available out of hours. The answer is that we have negotiated contractually with the BMA to ensure that within each area there are certainly a number of practices that might offer extended opening hours. I have no doubt that collaboration at local level will allow a degree of flexibility.

My Lords, has my noble friend noticed that there have been very few supplementary questions on this Question? That is one of the reasons why I am standing up now. Does that not reflect the fact that in this area of operation of the health service there is actually widespread approval of what the Government have been doing? People will quickly raise queries and complaints when they are there. It is not just in this area of the health service; as a general proposition, it holds true that while people may make generalised complaints, their own experience of the health service is one of overwhelming support for the doctors and nurses and for what the Government have been doing.

My Lords, I am grateful to my noble friend. To reaffirm the points he made, I understand that we currently have the highest satisfaction levels with the NHS since patient satisfaction surveys began.