Free for ALL for GPs
The Royal College of GPs in it’s latest publicity drive says that it does not think that a 7 Day per week GP service is achievable as the new Conservative Government has pledged. The argument rests on the issue as to whether there are or will be sufficient GPs in post to revert to a 7 Day service. My view is that the problem lies in the fact that NHS England no longer has any controls on GP Manpower. GPs can set their own agenda, set their own working hours and DO NOT have to account to anyone, perhaps except their partners for the days, hours or sessions they work. This ‘free for all’ was introduced in 2004 by the Labour Government as part of the new deal for GPs.
Part time working prevails
A recent survey carried out by KingfisherPM (gpsurgerymanager.co.uk) and supported by Practice Index (www.practiceindex.co.uk) found that more than 50% of GPs now work a four day week. So what happened to Day Five. Prior to 2004 GPs had to obtain the prior approval of a Primary Care Trust to work less than 5 days. Approval to work anything less than a 4 day week was rare and needed to be associated with a ‘special reason’.
Approving Part time working
What could these ‘special reasons’ be? As a former Deputy Administrator of a Family Practitioner Committee, I found that probably the most common reason for requesting a shorter working week was ‘family commitments’. It was therefore, an application from a female doctor that was on the table to be considered. I do not recall such an application being refused but such applications were not numerous. After that it may have been a male or female doctor who had an outside commitment that required one or more days outside the practice each week. One doctor for instance was a GP Training Course Organiser. There was a tendency for GPs to undertake outside commitments but to do these in their own time and not reduce their working week. But times have changed. The reasons given for working ‘part time’ now include ‘preparing for retirement’, ‘working for the CCG’, ‘family friendly hours’, ‘better work life balance’, et al. GPs are starting their career in general practice working four days a week without a specific reason. Yet as GP Registrars they will have worked full time costing the NHS a full time salary.
Take Back Control, NHS England!
In 2015 my recent survey showed that a large proportion of GPs work four or less days a week. No reason will have been given to NHS England, unlike before 2004. The freedom given to General Practice to run it’s own affairs has effectively backfired. The general management of general practice is out of control and as such it will be very difficult to wield a big stick and marshal GP numbers, and sessional commitments into a general practice coral. More GPs and more funding is fine but the NHS needs to know and understand how these funds and extra manpower are used and if not why not!
Robert Campbell – Writer on general practice management