Sick of this flexibility

Neal Lawson writes on GP opening hours

The government wants doctors' surgeries open more often and for longer. It has invested in the service and paid GPs more. Now it wants the public to get what it thinks the public wants - more flexible access to surgeries.

Who could argue with that? Well, let's try.

Why do we need extended surgery hours? Are we any iller or ill more frequently today than in the past? Not a bit of it. The nation is much healthier.

The real problem is that people's lives are busier and faster. They are working longer, harder and are up to their necks in all manner of additional time demands, such as undertaking home improvements, travel and helicopter parenting. So it is assumed that they want public services to fit their busy schedules.

But forcing workers - in this case doctors, nurses, receptionists and cleaners - to work extended hours merely ratchets up the problem, because these workers are not just producers; they are also consumers.

We are in a vicious spiral of market failure. If we want everywhere to be open, accessible and flexible for us 24-7, then, ultimately, we get the same done to us. We, too, will have to work more inconvenient and extended hours. We will see less of our families and friends. This proposal views the doctor's surgery as a convenience store - open all hours. Our demand for public services to be like Springfield's Kwik-E-Mart in The Simpsons is a symptom of the treadmill society.

But just because our own lives are out of control, our response should not be to wreak havoc on the lives of others.

Instead of forcing everywhere to be open at all hours of the day and night, we should try to ensure that we, too, rebalance our cash and time and start to live more structured and less pressured lives. This should be the ambition of a social democratic government: to stand up for the needs of society - not to allow market forces to flatten the space and time we have to be human.

If the customer (or, in this case, the patient) is king, the producer can only be the flexible servant. But we are all producers as well as customers. The circle cannot be squared.

What is convenient for the consumer is wholly inconvenient for the doctor, his or her staff and their families.

We are demanding of the world that it operate according to the time demands of capital, not human time. Keeping surgeries open all hours will end up making us all ill. It's not a convenience for the patient but a signal that society is becoming sicker.

Neal Lawson is chair of Compass

Neal Lawson is chair of the pressure group Compass, which brings together progressives from all parties and none. His views on internal Labour matters are personal ones. 

This article first appeared in the 11 February 2008 issue of the New Statesman, Now it gets really dirty