In message <[log in to unmask]>, Paul Caldwell 
<[log in to unmask]> writes

>there seems to be ever more in the press and from politicians about GPs 
>going back to doing extended hours, possibly even longer than before 
>opt out, afterall we r grossly overpaid, dont give value for money and 
>everyone else is jealous.

Interesting, isn't it?
The Casson report on OOH services laid down structures that *prevented* 
individual practices or GPs providing OOH cover, the nGMS contract 
priced the amount GPs would have to pay to opt out as a proportion of 
the basic practice funding, the new system of OOHs (and remember all the 
co-ops which went out of business because commercial providers were 
preferred?) - and the DH did a survey with questions *designed* to get 
answers expressing discontent - and only 16% expressed discontent - and 
only 4% wanted longer evening opening, **and yet** the press releases 
and actions of politicians and press would suggest that there was a 
massive groundswell of discontent with the current 10 and a half hours 
per day opening times...
Interesting approach - if the results of an expensive survey *don't* 
show what you want, continue to trumpet that they do!

Don't you love the lack of EBP (Evidence Based Planning)?
No wonder the NHS is in a mess - and likely to get worse!

>From list members closer to the Centre than moi, what is the most 
>likely outcome?

Centre of what?
I'd suppose that the *political* outcome will depend on the date of the 
next election - and nothing concrete likely to happen before..

>I've talked this a bit in and outside the practice. If my large 
>practice had to open 8-8 weekdays, and do surgeries sat and sun am, we 
>would take the time back ie work shifts 8-2 2-8 weekdays and if working 
>a weekend would not work monday or tuesday.

At present we take responsibility 55 hours a week - well above the 
European Working Times Directive. (Yes, I know this does not apply to 
self-employed partners): 8-8 (12 hours a day) + say 4 hours Sat and Sun 
gets us to 68 hours.

Shift work would definitely be needed - I've seen enough burn-out 
already..

>this would have left x2 doctors in our practice on monday am for 15K 
>pts! and pts would moan at that too.

I'm sure they would - but they could, of course, be directed to the new 
late surgeries.. To co-incide with children's bedtimes and Big Brother!

> hull has a large number of small practices and single handers who are 
>aghast at the proposals. many are anyway not far off retirement and 
>have said they'll go early, fearing the effect ontheir health if they 
>dont.

Tell them to hold on until it does..

>Hull pct is already unable to fill vacancies and the effect could be 
>catastrophic. I expect similar concerns from other areas have been 
>expressed. i may well put family before practice and go 
>non-principle-dont think i'll be short of work hereabouts either!

I suspect that that is the agenda - think of the walk-in centre where 
the doctor resigned: GPs are an awkward lot - harder to suppress than 
people with a line manager who can himself be bullied (see relationship 
between SHAs and PCT CEOs ;-<) - and how long will practices be able to 
afford non-principals - who in any case, speaking as a partner in a 
practice which has had to employ rather a lot , seem to dictate the 
hours they are prepared to work and charge so much that they will soon 
be unaffordable - and also have families!

>seems everyone demands their 'right' to consult a GP at the click of a 
>finger but no one has thought through the practicalities or -ve effects.

Be fair, Paul - it's only the politicians and press - not, according to 
the survey - the patients!

MaryH
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