The government is to take a "carrot and stick" approach in a bid to get GP surgeries to open more flexibly during the evenings and weekends, a health minister has said.
Ben Bradshaw echoed Prime Minister Gordon Brown's call that patients should have greater access to family doctors.
Mr Bradshaw also said it is important that GPs are rewarded properly for the work they do, and revealed there was a need to recruit and retain doctors when Labour came to power back in 1997.
But he added: "However, I think there are problems with the existing contract."
More and more people in the "consumer age" want more flexible opening times to fit around their lifestyles and working hours, he said.
Speaking at a Labour Party conference fringe event, Mr Bradshaw also hailed Lord Ara Darzi's review of the NHS.
He said: "Ara will press GPs to open more flexibly and in the evening."
He was also asked if carrots or sticks will be used to get GPs to open outside of office hours, to which he replied: "Both."
But Hamish Meldrum, chairman of the British Medical Association (BMA), said it is not simply a case of when GPs open their doors.
There needs to be more cash, more staff and increased access to diagnostic services, he added.
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"It would seem that the financial sacrifices made by GPs with regard to OOH at the beginning of the new contract have been completely overlooked. PCTs should be brought to account for OOH as this is their responsibility" - Name and address supplied
"People must understand that it is not just the GPs who help run the surgery. Staff currently have contracts that may not include the need to work evenings and weekends. We will either have to recruit additional staff (not easy) or reward our current staff for the unsociable hours they will be expected to work. Either way, the money for extended opening will have to come from additional funding if GPs are not to take a cut in their salaries. Don't forget, our staff have a life outside general practice as well" – Reg Gill, Practice Manager, Dumfries
"What does this government actually want? Do they know? I don't think so. The contract in place is a direct result of negotiations with this government. The agreement was that GP surgeries would be responsible for patients from 08.00 to 18.30, Monday to Friday. PCTs would have the responsibility for patients outside of those times. This has obviously failed through under-funding and other government related reasons. Nowthat there is flak flying about from patients, the goal posts of responsibility has been moved, at least in the eyes of the government. It is now the GPs responsibility to provide surgeries outside of the agreed times and also Out Of Hours cover as well. No? Well then why does the government insist on telling world that GP Out Of Hours is failing? Should that not be PCT Out Of Hours is failing? So, under what premise have they formed this opinion I ask? Certainly not under any contractual one" - Name and address supplied
"Once again this government, or rather ministers in this government, have lost track of what the real issue is. The 2004 contract was negotiated with them not their Conservative predecessors and it does them no credit at all to now blame doctors for doing what they are being paid for - and doing it very successfully. Perhaps they want GPs to fail as part of their self-justification and glorification. Hamish Meldrum ahs hit the nail right on the head, without proper resourcing, opening longer and at weakens is not an option. I won't work more than 37.5 hours without recompense and I would not expect my staff to do so either. And we do not get the holidays that our legislators get in order to recover from the extra stress and strain their half-baked ideas put us through. Was it Winston Churchill who said: "Give us the tools and we will do the job." For tools read adequate resources. If I sound angry, you can bet your bottom dollar I am" - Name and address supplied
"We have asked our PCT for modest support to pay for additional receptionist time early mornings and late evenings. The reply was that flexibility must come without cost. So the carrots are virtual carrots it seems, but no doubt the sticks will be real sticks" - Name and address supplied
"What about the lifestyle and home/work balance of GPs and Practice staff?" - ST, Yorkshire
"A 24/7 Practice at A&E departments would help both GPs and A&E. A recent study showed a lot of patients went to A&E unnecessarily and could easily have been seen by their GP. This takes up a lot A&E staff time. The governemnt should appoint non GMS GP & staff to be based at A&E departements" - Mary Frizzle, Glasgow