Longer GP hours is a good idea, but costly

A flexible NHS is a great idea, but don't hold your breath

For those in full-time work or juggling family commitments, the plan for longer opening hours at GP surgeries has much to recommend it. For all David Cameron’s interest in the matter, however, it will not happen any time soon.

The first problem is, predictably, money. The Prime Minister’s Tory conference titbit yesterday was a pilot scheme in which 50 surgeries share £50m and keep their doors open from 8am to 8pm, seven days a week, in return. Not only is there no hint of a national policy to follow, though; there is also no hint of how it might be paid for. And, even if such significant sums could be found, it is questionable whether this – amid all the challenges of an ageing population – should be the priority.

Here, indeed, is the second problem. For all that there are many of us who are inconvenienced by GPs’ hours, the vast majority of those using Britain’s surgeries are the elderly, not those in full-time work, or with children, or both. Indeed, it was this that put paid to the last such trial, under the previous government; outside the major urban centres demand was simply too low to justify the considerable extra cost.

True, there is a problem with out-of-hours care (although there is also evidence that the spike in Accident & Emergency visits may be young people wanting instant attention as much as those whose GP is unavailable). Simply keeping surgeries open until 8pm will not solve it, though.

All of which is not to argue against a more flexible NHS, or against services designed around patients rather than institutions. But Mr Cameron’s pilot, while welcome, is more of a gesture than a plan.