In his desperate quest to find some distinctive policy to distinguish his ascent to prime ministerial office, Gordon Brown has latched on to the notion of extending access to GP services outside conventional working hours. He seems to be committed to the principle of ‘unscheduled’ care, offering unrestricted access to patients, irrespective of whether their complaints are serious or trivial, acute or chronic. While the media extol the virtues of primary health care on the Tesco model, there appears to be little public objection to the emergence of surgeries staffed by security guards and the healthcare equivalent of the minimum-wage shelf-stacker — or the call-centre shift-worker — providing instant advice and treatment according to the dictates of a computer algorithm.
As Iona Heath has argued, the reorganisation of out-of-hours care following the introduction of the new …