Complaints over GP appointments still await a cure

A poll of almost 117,000 people across England by the Healthcare Commission found the majority were happy with the care they received from local doctors and dentists.

But 30 per cent said they could not book an appointment three or more working days in advance.

Speaking on the BBC Breakfast programme, the Health Minister Lord Warner said: "I have admitted it is not good enough, and that is why we want to take action with the public, and the BMA [British Medication Association] and the GPs to come up with a system which doesn't lose the urgent access within 48 hours, but at the same time produces flexibility.

"And we know it can be done, because although a third or so, as the Healthcare Commissioner pointed out, of practices are not delivering this, what it shows is that two-thirds are delivering it."

He has previously said it was "unacceptable" that some practices were still not allowing patients to make advance appointments, adding: "There is absolutely no justification for this target being used as an excuse for an inflexible appointments system."

Patients have complained that Government targets stating that patients should wait no more than 48 hours to see a GP, or 24 hours to see a primary care professional, have led to surgeries stopping advance bookings.

Instead patients are told to call back nearer the time they want to be seen.

In April Prime Minister Tony Blair was put on the spot over the issue on BBC1's Question Time, when members of the audience told him they could only book appointments within 48 hours, or on the same day, because of Government targets.

Today Diana Church, the woman who originally taxed Mr Blair, said that she had tried to make an appointment a couple of weeks ago, saying: "I don't think it has got any better."

She told the programme she was "inundated" by people telling her they had tried to book in advance with their surgery: "They seem to have made access so much more fraught and more difficult.

"The system possibly works well for people who can go to the doctors at the drop of a hat, drop everything and run to the doctors, and they suddenly manage to get an appointment, but most of us work, or have caring responsibilities, or we need to be able to organise our lives around being able to see the doctor when it is routine. I'm not talking about emergency appointments here."

Noting that two weeks ago they were "completely denying there was a problem", she added: "That is just not the experience of people on the ground."

As the Healthcare Commission report was published, the Department of Health said it would be introducing measures to guarantee that patients were able to book an advance appointment.

The survey found that only 12 per cent of patients had been unable to see a GP within two working days, and 13 per cent did not get an appointment in that time because they wanted to wait longer to see a particular GP or for a more convenient time.

The poll also found that 41 per cent of patients thought that they should have been seen sooner than they were - down from 43 per cent last year.

Patients also reported difficulties accessing dental care and seeing an NHS dentist.

The poll found that 57 per cent of people were registered with an NHS dentist.

More than two-thirds (69 per cent) of those who were not registered with an NHS dentist said they would like to be.

But for those lucky enough to have an NHS dentist, there was widespread confidence - with 75 per cent saying they definitely had confidence in their dentist and 60 per cent saying they felt involved in their care.

The survey also found that patients were broadly positive about their experience with local doctors.

More than three-quarters said they definitely had confidence and trust in their doctor, and 92 per cent felt they were always treated with dignity and respect.

Six out of 10 (59 per cent) of those given medication said they were involved as much as they wanted to be in decisions about the treatment, and 89 per cent were given enough information.

But 18 per cent said they were not given any information about potential side effects with medication.

Anna Walker, chief executive of the Healthcare Commission, said: "This major survey of patients gives us an invaluable insight into what patients think about their access to primary healthcare and the quality of care that they receive.

"We recommend that patients' views should, in the future, be taken account of, along with those of GPs and other primary healthcare professionals by all organisations assessing performance."

She added: "Although timely access to GPs and dentists is important, the quality of care that patients receive from their GP, dentist or midwife, is also crucial and, according to patients, it is extremely good."

The Government is currently carrying out a public consultation on how to improve care outside hospitals.

The DoH said there would now be tighter checks by primary care trusts to tackle restrictive booking practices.

Lord Warner said: "We will make our system of checks more robust to ensure achievement of the target truly reflects the experience of patients across the country."

The DoH said they would ask patients and NHS staff what timescale they wanted to see in terms of a national guaranteed advance booking period as part of the White Paper consultation.

They pointed out that virtually all patients could now see a GP within two working days, or a primary care professional sooner.

Lord Warner insisted his comment that 99.98 per cent of patients were being seen within 48 hours was made in good faith, despite today's survey findings.

He said his figures had been based on what GP practices had told primary care trusts.

He said on BBC Radio 4's Today programme: "If they were wrong and they don't represent the patients' view, they are the views which were coming from practices themselves."

He added: "We have not thought to deceive people. We have thought to put in the public arena what the practices told us."

He said the survey today showed that 70 per cent of patients had access to a GP within 48 hours, and also had flexible access.

"A very large number of GP practices are both maintaining urgent access and flexible booking.

"What we've got to work on is the rest," Lord Warner said.

The number of GPs was going up by about 1,000 a year, with practice staff numbers rising even faster.

He said the Government was consulting on a White Paper and added: "We want to get to the bottom of this. We want to listen to the public and we will be doing that over the coming months before we come to a decision."

Diana Church hit the headlines during the General Election campaign for challenging Tony Blair over the issue of access to GPs.

Responding to the survey, she said on the Today programme: "I find it surprising that only two weeks ago the Health Minister was saying there was absolutely no problem, it's a problem affecting about only 100 surgeries, less than 1 per cent - when this survey was carried out at the beginning of the year."

She said: "I was asked to come back by the doctor to check that my son was better and I wasn't allowed to make the appointment for a week's time. I had to ring back the day before to make the appointment.

"It's like an 8.30 lottery. You have to be on the phone at 8.30, ringing constantly, pressing redial."

Dr Hamish Meldrum, chairman of the British Medical Association's GPs' Committee, told the programme the only way to solve the problem was by having more doctors and nurses.

"The basic problem is we haven't got enough doctors, and therefore there is always going to be demand outstripping resources."

Criticising the Government's policy of access to a GP within 48 hours, he said: "If you skew the system by forcing doctors, or encouraging doctors, to keep a lot more appointments free to be booked on the day, then common sense tells you there are fewer appointments left to book ahead."

He added: "There's a financial incentive to actually offer appointments within 24 or 48 hours."