Access dispute masks challenge to deliver better primary care

The rubber chicken circuit is over for another year.

For those who attended the three major party conferences, there will be a greater knowledge of how the Clyde has been transformed as a site of boat building to (for the Lib Dems) one of vote-building: an opportunity, alongside Ed Milliband, to dip a toe into the waters of Brighton and frozen utility prices and, in an uncharacteristically dry Manchester, to hear more about additional funds for some GP surgeries. It is on the last of these that I would like to concentrate.

David Cameron's response to the growing problem of crowded accident and emergency departments and a real or perceived belief that general practice could do more is the same as that of senior politicians since Aneurin Bevan and the establishment of the NHS. To get through his bill, Bevan "stuffed their mouths with gold".

Today, Cameron's proposal is additional funding for a number of practices, in exchange for longer opening hours. It's a response which in the short term appears expedient, since it delivers immediate extra capacity into the system and gives the appearance of action. But does it do much good?

Those who follow emerging health statistics will know that the growth in attendance within A&E departments has grown exponentially in the last couple of years. At one level, the introduction of triage several years ago, by which patients were seen for an initial consultation, usually with a nurse, helped to massage the figures. While you might have been initially seen in the first 15 minutes, you then joined the walking wounded for several hours hunkered down in a crowded waiting room.