David Cameron should abandon his “surreal obsession” with patients being able to see a GP until 8pm every night because there are too few family doctors to deliver his pledge, a prominent GP trade union leader is warning.
Dr Chaand Nagpaul urged the prime minister to accept that general practice is heading for a catastrophe because more GPs are retiring early and fewer junior doctors want to join the profession.
“Now the election is out of the way, I call upon our prime minister to jettison the political pipe dreams of tomorrow and get real about how we resource, resuscitate and rebuild general practice today,” said Nagpaul, chair of the British Medical Association’s GPs committee.
One in three GPs are thinking about quitting the profession in the next few years because of the “unsustainable, punishing pace and intensity” of their roles, said Nagpaul. “It’s absolutely pointless promising 5,000 extra GPs within this parliament if we lost 10,000 GPs retiring in the same period.”
The government, said Nagpaul, “will fail dismally in its manifesto pledge for 5,000 extra GPs” because overwork and bureaucracy are prompting so many family doctors to retire, move abroad or switch to other branches of medicine.
Longer opening hours, with patients able to visit a GP surgery between 8am and 8pm every day of the week – which Cameron has been pledging since 2013 – would not happen due to a lack of doctors, Nagpaul said.
“Ministers must halt their surreal obsession for practices to open seven days where there aren’t the GPs to even cope with current demands. This would damage quality care by spreading GPs so thinly and will reduce GPs’ availability for older vulnerable patients,” said Nagpaul.
“Unless it [the government] turns this around we won’t have a comprehensive general practice service in parts of the UK.”
The NHS has missed its target to persuade 50% of medical graduates to become GPs rather than other sorts of doctor for the last two years.
The Department of Health described Nagpaul’s remarks as “overly negative and pessimistic”.
“Thousands of GPs across the country are already offering patients GP access seven days a week. By next March, a third of the country will be covered. We have made it very clear that we will train 5,000 more GPs and have backed the NHS’s own plan for the future by investing the £8bn it needs to transform care closer to home,” said a spokesman.
But Dr Maureen Baker, chair of the Royal College of GPs, also took issue with Cameron’s all-day-opening promise.
“Many practices are already offering extended opening hours but for the majority, seven-day opening remains an aspiration and telling patients that they can walk into their local surgery in the evening or at weekends risks raising expectations that general practice cannot live up to with current resources.
“Access to GP services is extremely important but prioritising weekend and evening access must not come at the expense of access and services during normal hours so that patients end up worse off,” Baker said.
