A Westcountry GP-turned-MP has warned access to doctors' surgeries in rural areas could be reduced under plans announced by David Cameron for them to be open seven days a week.
Former Dartmoor GP Sarah Wollaston, the Conservative MP for Totnes, has warned the "workforce crisis" in primary care will make it difficult for countryside practices to be open all hours.
The Prime Minister today announced a £50 million trial to encourage longer opening hours, which will include nine pilot projects in areas across England, to ease pressure on stretched A&E departments.
Dr Wollaston, a family doctor until elected to Parliament in 2010, supports a seven-day GP service. But she is concerned that the goal will be impossible to achieve without more GPs and nurses.
Speaking to the Western Morning News at the Conservative Party conference in Manchester, she said she was worried the plan would fail if politicians are "dictating how GPs have to do it".
And Dr Wollaston said rural towns and villages risked getting less access to doctors if the pilot seven-day services attracted doctors to urban areas.
She went on to argue small practices could struggle to stay open at weekends in any case – whereas larger city practices could adapt.
One reason is because rural GPs could not join forces with other practices because of difficulties over sharing patient records.
She said: "You could make access to GPs worse in some parts of the country by putting money into pilots in urban areas. The question is are we going to make it even more difficult to recruit GPs in rural areas.
"The danger is we raise expectations that this will be the magic bullet for GP access. But that won't happen unless you address the problem of the workforce crisis.
"If you have a small practice in rural Devon with only two doctors, how are you going to be able to roll this model out? It could be different if you have a large practice. If you have six doctors you might be able to come up with a solution."
Dr Wollaston – who has not seen or been consulted on the plan – said she was disappointed people with "lived experience and expertise" had been excluded from formulating the policy, and argued against "top down" Whitehall edicts driving the implementation.
Under the scheme, the extra cash is being offered to groups of GPs proposing the most effective ways to improve access.
As well as extended surgery hours, ministers hope they will pioneer more effective use of technology – such as carrying out consultations with patients via video calls, email and phone.
Electronic prescriptions, online appointment booking and allowing people to visit a number of different surgeries across an area are also measures being sought from the first wave.
Mr Cameron said: "Millions of people find it hard to get an appointment to see their GP at a time that fits in with their work and family life.
"We want to support GPs to modernise their services so they can see patients from 8am to 8pm, seven days a week.
"We also want greater flexibility, so people can speak to their family doctor on the phone, send them an email or even speak to them on Skype."
The first pilot projects are due to be operating by April 2014 with the hope they will be copied widely across the country.
Officials said the 8am-8pm seven-day hours would not be a requirement for successful bids but made clear that was the expectation.
Similar initiatives are already being tried in some parts of the country - including parts of Manchester, where some surgeries will move to seven-day opening.
But critics say there is already a shortage of GPs because of a retirement "bulge", more female doctors working part-time to raise families and a trend for medical school graduates to seek consultant hospital jobs that do not exist rather than go into general practice.