Round the clock GP Care?

'Tis the season to be jolly and the Party Conferences have not disappointed. The reds and blues have vied with each other for the most attractive headline pledges to squeeze as many votes as possible in time for X-factor 2015. Although most of these pledges will be long forgotten by 2015, this morning's intention to extend GP opening hours will be alive and kicking. Far from being a new concept, this particular football has been kicked around for a number of years now as a succession of governments have toyed with ways to reduce the demand on A and E departments. You can see their point. They can't go on like this so a move to divert some of that load to a local GP appears, on the face of it, to make sense (provided they are prepared to pay for the privilege of course). As an interim measure, it is inevitable because the current levels of demand are just unsustainable. But that is the point: it can only be an interim measure. This is because the real challenge remains. While this and previous governments remain focused on what is coming out of the health pipeline in terms of A and E admission rates, they are ignoring the business of why people are entering the pipeline in the first place. Their current proposal amounts to political tennis in which the problem is batted back and forth from one side to the other. The real challenge is to reduce the burden on the NHS as a whole - whether that is primary or secondary care. This is only going to happen with a cast iron long term strategy which needs to begin in the home and at pre-school level. It is the latter stage which holds the key. It just isn't realistic to expect to change the health decisions of people in their 3rd decade and beyond. You may get some success with the odd one but these will constitute the exception rather than the rule. It is at a pre-school age that real change can be effected. This will only be achieved by connecting with parents and the best way to do this will be to connect with communities. This is going to need everybody to get involved such that the healthy role models are the norm. At present, local government is about as disconnected from local communities as they can possibly be. This problem will remain until somebody does a rethink on the size and scope of local government. In its current form, it is far too political with the emphasis being too skewed towards job preservation rather than real public service. It is a massive mistake to imagine that this problem can be overcome by spending vast sums of money on local government. We know this because Labour proved it from 1997 until 2010. Putting local government to one side though, the Westminster government can and should be doing a lot more to curtail the destructive impact of the big four supermarkets on the health of the nation. Lets be quite clear about them. Their interest is in profit, pure and simple. How they make their money is not important to them. Whether they're selling alcohol or vegetables is a matter of complete indifference. They are completely at liberty to sell whatever they want at whatever price they want irrespective of its effect on addiction or just general health. This and previous governments have created this four headed beast. They now face the daunting task of reining it in. That will take a political giant and at present we have a selection of political jellies.