Doctors told to open all hours to improve access for patients

Practices will be asked to open as early as 7am and as late as 10pm, her officials said. GPs also will be asked to provide a wider range of services at their practices, such as direct access to medical tests and local care for diabetes, asthma and arthritis.

Ms Hewitt's plans, which will be set out in a White Paper in the autumn, are part of a strategy for dealing with complaints by patients that they cannot get appointments with GPs when they need them. A recent report by health watchdogs found that more than five million patients were finding it difficult to get access to a GP despite promises by ministers last year that everyone would be able to get an appointment within 48 hours.

During the general election, Tony Blair was caught off guard over a complaint from an angry patient that the 48-hour target meant it was impossible to get a follow-up appointment a week later. He said he was "absolutely astonished" that GPs were refusing to make appointments more than two days in advance in an attempt to meet the target.

Ms Hewitt, who was ordered to sort out the problem, said thousands of people would soon find it easier to visit a GP thanks to a wave of new GP practices and walk-in services due to open next year in towns and cities that have the poorest access to primary care services. Six primary care trusts (PCTs) will get extra government support to improve patient access to NHS care without being referred to hospitals. The first patients to benefit under the programme will be those in London (two PCTs), Liverpool, Lancashire, Plymouth and Yorkshire.

With support from the Department of Health, PCTs in these areas will open three new walk-in services; two new GP practices; one nurse-led practice and employ more GPs, nurse practitioners and healthcare assistants. Ms Hewitt said GPs will have more power to commission services so local health care reflects the need of the community. By 2006, all PCTs will allow GPs to hold a budget for the treatment of their patients under practice-based commissioning.

Ms Hewitt said: "We are also going to bring forward practice-based commissioning so it is in operation across the NHS by 2006 rather than 2008, as we previously said. GPs are responsible for the vast majority of NHS patient contacts and commit the bulk of NHS resources through prescribing, treating and referring patients to other services. There are obvious benefits to patients if GPs control the budgets."

Patients in about 15 other areas affected by below-par GP recruitment and retention, limited GP availability and rises in population could also gain new services at their local practice as part of a second wave.

Dr Hamish Meldrum, chairman of the BMA's GP committee, said the 48-hour target was "not helpful in dealing with the underlying problem which is a shortage of capacity ... a shortage of GPs".

The Government has launched a fresh recruitment drive, but it takes years to train new GPs.

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