Access: For what price?

We wrote recently about the 'why' of 'access'. However the government is desperate to get GP opening hours extended into the evenings, and within “the same overall cost envelope”.

So the government is so really keen to get better access that it is willing to spend nothing to achieve it. The NHS alliance has put out a useful press statement.

As we revealed this week, the negotiations between the BMA and the DH have shown what the government might be willing to trade, and how they intend to threaten us, to get it. It seems that the government would value one hour of late evening surgery as being worth twice a daytime surgery. So a practice could open once a week to say 9pm, or for an hour on a Saturday, and close for twice as long another day. In other words we could open less and earn more. We’d have to pay our staff for funny hours, but we’d get someone in and manage it.

Would this be a good deal for patients?
NO- they’ll overall lose GP availability. The people with major illnesses, the retired folk with co-morbidity, the ones in whom most medical work is needed would get less access. The office worker with minor viral infection, and the girl who’d run out of her pill would do better. Medically such a trade would represent taking resources away from the sick and towards minor illnesses.

Would this be a good deal for taxpayers?
NO- you cannot get something for nothing, despite what PBC is supposed to achieve.

Would this be a good deal for doctors?
Not really, but we would adapt as always, to severely skewed incentives.

Is the DH going to get a good deal for patients and taxpayers here?

Like fuck they will. Of course not.