GPs' patients want more flexible services

A survey of NHS patients confirms that they want fast and convenient health services.

The survey, promised in the government's white paper The NHS: Modern, Dependable, published in 1997, was conducted by a consortium led by the National Centre for Social Research. It surveyed 60 000 patients and looked at access, waiting times, communication between patients and GPs, out of hours care, competence, and helpfulness.

People in paid work or full time education said that they wanted better access to services, often outside normal surgery hours, and younger people (under 45) and those from ethnic minority groups were generally less satisfied than the rest of the population with the health care they received.

Although four out of five patients thought that their appointment with their NHS GP was as soon as necessary, 15% of respondents (and 20% of people in work) said that they were put off going to their GP because of inconvenient surgery hours. Only just over a quarter of practices (27%, covering 38% of patients) offered access to GPs before 9 am or after 5 pm every weekday.

Seventy eight per cent of patients considered that their GP “took their opinions seriously,” and 84% said that the GP “listens to them no matter how busy he or she is.”

Minister wants to cooperate with GPs

The government's social security minister has invited GPs to work with it to provide a more effective service for sick and disabled people claiming benefits.

Mr Hugh Bayley told the General Practitioners Committee last week that he appreciated that many doctors found the work involved in certification onerous, but he pointed out that the Department of Social Security spent as much in a year on incapacity and disability benefits as the NHS did on inpatients in England, Scotland, and Wales—£25bn Between 1979 and 1997 the number of people claiming diability benefits had trebled, at a time when people's health was improving.

The minister said that he wanted the paperwork to be reduced wherever possible. A training package about certification would soon be available and there would be new guidance to employers and GPs on the changing role of employers in dealing with sick staff. He hoped that GPs would cooperate with research into certification. The minister said that he would be happy to discuss the simplification of certification forms.

In response to a question from Dr Peter Holden, a GPC negotiator and chairman of the BMA's professional fees committee, the minister agreed to see where the responsibility lay for the pay of doctors employed by the benefits agency. Dr Holden told him that their pay had not been increased for seven years. The DSS was the only department which had not adopted the Treasury's rates, and the minister, Dr Holden said, now had an opportunity to right an injustice.

Dr David Pickersgill said that a new appeals mechanism was needed as there were often difficulties for GPs when patients were refused benefits and appealed. Mr Bayley said changes were being made to speed up the process and ensure that the right decision was made in the right place. But claimants had nothing to lose in appealing and they often wanted their GP to back them. The benefits agency doctors were seen as working for the opposition.

Academic staff should be covered by EU directive

The BMA's Medical Academic Staff Committee believes that clinical academic staff should be covered by the European Union 48 hour working time directive agreement as it applies to senior hospital doctors in the NHS.

The Universities and Colleges Employers Association has obtained a legal opinion on the directive's application to clinical academic staff, which suggests that the unmeasured woking time regulations apply, despite fixed clinical commitments, and clearly timetabled teaching sessions. The MASC is seeking legal advice about this.

Medicopolitical digest is prepared by Linda Beecham