NHS IN CRISIS: ‘The system is creaking and it isn’t just the GPs’

Dr David  Wrigley
Dr David Wrigley

Working from 8am until 8pm, seven days a week. That’s the hours the Government says GP surgeries should be open, in a bid to cut the pressure on over-stretched hospitals.

Reporter Mark White speaks to Lancashire GPs to find out if they think these demands are realistic and what they believe the future holds.

Royal Preston Hospital A&E
 Department 
entrance.

Royal Preston Hospital A&E Department entrance.

“Doctors are working their socks off and these requests are just a smokescreen to hide the government’s incompetence.”

That’s the strongly-worded view of Dr David Wrigley, Lancashire GP and deputy chairman of the British Medical Association (BMA), in response to Government calls for better access for patients to GP surgeries.

Number 10 last week linked the reports of excessive waiting times in accident and emergency departments to GPs not providing a seven-day service - provoking a furious reaction from the British Medical Association that hard-pressed GPs were being “scapegoated.”

Dr Wrigley, who is based at Ash Trees surgery in Carnforth, claims a lack of resources and funding is killing the profession.

Lots of practices have vacancies for doctors because junior doctors aren’t choosing the route of general practitioners and if they are, they’re leaving the career early because of the pressures of the job.

Dr Wrigley

He said: “Firstly, I hope the Prime Minster was asking for practices to open all week and not for doctors to work seven days, because that would be bonkers.

“GPs are already struggling to cope with the Monday to Friday demand with very few resources.

“Lots of practices have vacancies for doctors because junior doctors aren’t choosing the route of general practitioners and if they are, they’re leaving the career early because of the pressures of the job.”

Surgeries are currently expected to open between the core hours of 8am and 6.30pm Monday to Friday. Extra funding is available to those offering appointments outside those hours.

A Downing Street statement said: “Most GPs do a fantastic job, and have their patients’ interests firmly at heart.

“However, it is increasingly clear that a large number of surgeries are not providing the access that patients need - and that patients are suffering as a result because they are then forced to go to A&E to seek care.

“It’s also bad for hospitals, who then face additional pressure on their services.”

The government highlighted October 2015 figures from the National Audit Office (NAO), which showed that 46 per cent of GP surgeries closed at some point during core hours, and 18 per cent closed at or before 3pm on at least one weekday.

The NAO said three-quarters of those that closed early were receiving extra funding in 2015-16 to provide access outside of core hours.

Number 10 also said ministers had been shown evidence that some GP surgeries were failing to tell patients about extending hours for appointments or ensuring they were at convenient times.

It said patients not seen outside working hours were “left with little option” but to go to A&E.

But Dr Wrigley said these claims were far from true and extra funding was desperately needed if more hours were to be pushed on doctors.

“There are just not enough doctors to open any more than we already are,” he said. “Doctors are already working 12-14 hours a day with no time to think or look back at you’ve been doing.

“Surgeries closing during core hours and before 3pm on weekdays are few and far between. Most don’t, and work very long hours.

“I can see the benefits of opening on a Saturday as I think there is a strong demand for that but there isn’t really on a Sunday. GPs aren’t against working weekends, but there aren’t enough doctors to work more than five days a week. Working a weekend would mean not working one or two days through the week.

“But I still don’t think it would take the pressure from A&E departments. Hospitals just don’t have enough beds to cope. It comes down to being grossly underfunded and understaffed.

“We are heading towards a car crash and we are already in a crisis.”

The government also said the director of acute care for NHS England, Professor Keith Willett, has estimated that 30 per cent of patients attending A&E would be better cared for elsewhere in the healthcare system.

And Preston GP, Cameron Wilson, thinks the time has come for people to pay for healthcare “if there’s any chance of saving the NHS”.

The doctor at The Healthcare Centre on Flintoff Way, said: “I don’t think the general public knows how bad things really are and that’s down to the outstanding professionalism of NHS workers.

“Asking a service which is already at breaking point trying to provide care five days a week to stretch even further isn’t the best management policy.

“The system is creaking and it’s not just GPs, it’s the whole NHS. For the government to ask for this with no resources to spare is a kick in the teeth.”

And Dr Wilson says meeting the government’s demands wouldn’t take the pressure away from A&E services.

“We’re at capacity right throughout the system. We can’t take extra strain and neither can they,” said the doctor of more than 30 years.

“Charging a nominal fee to be seen at A&E would certainly help because people would think twice about going. It would mean people would take more responsibilty for their own health.

“In the absence of more funding, the funding is going to have to come in the form of an insurance-based system like so many countries around the world use.”

Figures show more 
than four in 10 hospitals in England declared a major alert in the first week of the new year as they faced unprecedented pressures.

But Dr Wilson says those pressures will start to become the norm.

He said: “We didn’t have a bad winter. There weren’t any bugs going round, this is just set to be a year-round problem.

“The profession has been flagging this up for 10 years but the government keeps burying its head in the sand.

“If there’s any chance of saving the NHS, I think we’re going to have to start paying for it before it’s too late.”