Surgeries close to collapse, GP warns

Dr Peter Holden, special advisor to the BMA General Practitioners Committee on premises, out of hours care and rural matters, said GPs already provide 24/7 emergency cover and always have done.

What changed in 2004, he said, was that responsibility for arranging the cover was transferred away from GPs to Local Health Boards in Wales and Primary Care Trusts in England.

He was today due to lead a debate about the government's proposed seven-day opening of GP practices for routine care on the eve of the annual Rural Primary Care conference in Mid Wales. The conference, to be held at Gregynog Hall, near Newtown, from September 30 to October 2, will bring together GPs, trainee doctors, practice nurses and managers from England and Wales.

Dr Holden said: "General practice is currently functioning only because of the professionalism and dedication of doctors, nurses and staff, but the daytime pressures, let alone those out of hours, are becoming impossible and therefore not sustainable in the long term."

He revealed that GP practices in England and Wales receive average funding of £140 per patient – less than the price of a television licence.

"For that you can have unlimited consultations, the services of all the staff, the surgery facilities and the GPs," he said. "Where in the world would you get that level of professional service for that amount of money?

"The system is in danger of collapse before 2020 because by then the critical mass of GPs will have retired. Twenty-eight per cent of GPs are now over the age of 58 and 40 per cent are over 55. It's now a question of how long people can remain standing.

"Morale amongst GPs is very low and many practices are one retirement or long-term sickness away from collapsing. Many practices can't afford a locum at up to £800 a day, even if they could find one.

"The other issues that are driving GPs out of NHS are pension changes and rising professional indemnity insurance. It's compulsory that I pay 29 per cent of my income into the NHS pension and pay for professional indemnity insurance, which was £50 a year when I started, is now £7,320 a year and next year it will be £10,000 because the nation has become more litigious."

Dr Holden said to open seven days a week would add an extra 40 per cent to practice costs.

"Patients must be prepared to stand with us if the service is to avoid collapse. Some patients now have completely unrealistic expectations due to the government playing politics and stoking things up with their comments," he added.