As part of their efforts to improve primary care in the NHS, in 2004 the government offered a new contract to GPs. This involved salary increases of about 40% in return for less work.
Few GPs now provide an out-of-hours service themselves, choosing instead to farm out the responsibility to a locum type service. They are also paid extra to undertake tests that patients do not ask for (blood pressure, cholesterol, and the like) when they pitch up with a sore throat.
The so-called �primary care� service at my GP�s surgery consists of prescribing anti-biotics and pain killers. Anything else results in a referral to a �specialist� (i.e. a doctor who will spend more than ninety seconds listening to a description of your problem) � and a three month wait. Patients needing a blood pressure check have to do it themselves on a machine in the reception area. Appointments are not available more than two days in advance (because of the 48-hour consultation target).
These limited services are available between 8:30am and 5:30pm, Monday to Friday. Closed for lunch 12:30 to 2:00, and Wednesday afternoon. This is despite the practice having at least six doctors and many more support staff. However, anti-obesity clinics, anti-smoking clinics, baby weighing clinics and the like are available a-plenty (because, of course, these result in additional �points� which enhance the GPs� pay).
GPs now routinely earn �100k plus for providing a limited service during restricted hours. The government is thinking it might have to renegotiate the contracts, whereas in fact they should never have been negotiated the way they were at all.