The Department of Health has ordered health authorities to radically expand patients’ access to GP services – using private care if necessary.

A letter by Mark Britnell, the Director of Commissioning for the Department of Health in England, has told NHS organisations to make GP surgeries more consumer-oriented and to expand GP opening hours, it has emerged.

This could mean using alternative providers, including private companies instead of GPs, the letter said. The news prompted a hostile response from the British Medical Association. Dr Laurence Buckman, the chairman of the BMA’s GPs Committee, criticised the Government for “failing to even attempt to talk to GPs about their plans”.

“It seems inappropriate to me to use this aggressive stance in ordering primary care trusts to take action,” he said. “Family doctor practice opening hours are agreed with the Government and were established after long and careful negotiations."

He went on the say: “There are already provisions in place for primary care organisations who want to resource extra opening. Very few have made use of these because they are not a good use of resources and because they reduce care for most patients during the day when most of them want to be seen.”

Expanding patient choice

However, expanding patient choice lies at the heart of government health policy and ministers seem unlikely to back down over expanding access to GP services. They are understood to feel that the doctors’ union is on the back foot as controversy mounts over the generous new GP contract which has seen family doctors’ salaries rocket into six figures - despite the removal of out-of-hours responsibility and relatively modest increases in productivity.

Michael Sobanja, the chief executive of the NHS Alliance, a group that represents primary care organisations, told The Times newspaper that if ministers were aiming to use competitive tendering to fill gaps in GP provision, that might not be a bad thing. He said, however, the move could prove counter-productive if it was used simply to force more GPs into working longer hours.

The pressure on the NHS to expand access to GP services was further highlighted last month when a major report by the surgeon and junior health minister Sir Ara Darzi called for GP 'polyclinics' that stayed open until 10pm.

The report Healthcare for London, commissioned by NHS London, the capital’s strategic health authority, called for a radical overhaul of London’s health services, which it said were “not meeting Londoners’ expectations”.

Sir Darzi said the 'polyclinics' would include GP surgeries, diagnostics such as x-ray and pathology, outpatient clinics, urgent care, minor procedures and associated services such as pharmacies.