Do we need a 7 days a week NHS?

I don't really feel qualified to write about the NHS for so many reasons. Primary amongst these is the fact that our local surgery is very good; I have never had a problem getting an appointment, and they look after me very well. And they do it in 5½ days a week.

That said, news that the Health Secretary wants all surgeries to stay open seven days a week is something that we cannot ignore. There are many aspect to this issue.

First, pressure on A&E departments, particularly at weekends, is apparently such that some form of relief is necessary to stop the system getting gummed up - and thereby unable to deal with real emergencies. The problem is that many people seem now to use A&E as their first port of call, particularly in urban areas, because they cannot manage (or be bothered?) to find a GP surgery open at a time when it is convenient to them. This is an important point, because so many workers now have to cover shift patterns which make it difficult to be available during 'normal' hours.

We also have to recognise that we have an ageing population. As we get older, we have more - and more complex - health problems, which frequently demand greater attention from doctors. That said, many chronic conditions are actually managed by other health professionals and overseen by a general practitioner. It seems to work well, but demands effort on the part of patient and the medical profession, to ensure that all advice is accurate - and followed.

The number of GPs is also a major issue. It takes a decade to train one, so the chance of getting a further 5,000 in place by 2020 suggests that there should be at least this many in training currently, to allow for other specialisations and drop-outs. Paying a bounty for those going to work in 'medically deprived' areas sounds great, but one cannot help wondering whether the contracts that will be on offer are really as attractive as a partnership would be. The financial risks of self-employment may be greater, but the long term rewards can also be higher.

Flexible working is probably one of the best solutions, alongside having more of the right sort of individuals available (of which more below), but if this is to be achieved, we need to understand:

a) Whether patients in each area actually want Sunday appointments - most of us might like Saturday ones and the ability to see a GP from our own practice in an emergency at any other time of the weekend (or evenings), but Sunday as a 'norm' might be a step too far;

b) Doctors, like all of us, work far more effectively if they have adequate rest time - expecting them simply to cover longer hours without some form of trade-off during the working week would probably last only for as long as the current generation, who would want to take on such a role?

Resources are a key aspect of the NHS that should not be dependent simply on throwing more money at the system; we need to focus instead on making sure that we get better value for what we do spend. One way of doing this is to make greater use of technology, whenever possible, and also bringing more Practice Nurses and Pharmacists into the structure of GP surgeries. These health professionals are highly skilled and can take much of the workload from doctors, who can then spend more time with those who really need their attention, directing them to specialists, as required. Let's hope that the extra 5,000 health professionals Mr Hunt is planning for surgeries will fall into this category and not just more administrators.

As for opening seven days a week, the jury is still out.

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Stephen Phillips is a member of the Shepway Liberal Democrats, and his views are not necessarily those of the Party. He has been writing professionally for many years on investment and economic related issues, and has focussed recently on creative writing.

You can find Stephen online at www.phillips-writer.co.uk