If the Department of Health gets its way, you might soon be reading The Times' supplement, Body&Soul, in your GP’s waiting room on a Saturday morning.

After years of negotiation, a new contract and two annual pay cuts my surgery faces an ultimatum – agree to open for nine extra hours outside our normal working day of 8am to 6.30pm, Monday to Friday, or, you’ve guessed it, we’ll get another pay cut.

We’re getting used to them by now. Just like we’re getting used to comedians’ jokes about us earning £250,000 a year. Then there are the hilarious media quotes from Joe Q Public about never knowing what time he’s going to get ill, so why should his GP surgery close overnight?

For the same reason that your local garage isn’t open 24/7; you don’t need us. If your big end gives out at 3am you call a breakdown service and they get you home.

Your car mechanic doesn’t provide an emergency service and neither, unless you live on an island somewhere, does your GP.

Out-of-hours care is provided by your primary care trust and subsidised by your GP who donates £6,000 every year to the kitty that pays for it. If you are taken ill in the night, that’s who you call – unless you’re a 999 job.

The extra appointments that the Department of Health seems so keen to offer are for routine nonurgent care, the same run-of-the-mill stuff that GP surgeries provide, day in and day out; blood pressure checks, long-term management of illnesses such as asthma, arthritis and diabetes, employment medicals and diagnostics.

Much of this work is done by specialist nurses. Common sense would dictate that they’d be called upon to work the extended hours as well.

But they have a better trade union than we do so the deal on the table insists that the additional appointments are with doctors, rather than the people best suited to do the work. Come and see me for a routine nursey thing like a contraceptive implant in your arm tomorrow and you’ll see what I mean.

I’m not saying that I wouldn’t get it into the right place eventually – of course I would – it’s just that practice makes perfect and you might be a bit pissed off when I came at you with a big needle for the third time.

Of course, we wouldn’t be expected to do all this extra work for nothing. If you’ve ever wondered who pays to light and heat your surgery or who pays the reception staff who greet you at the start of your patient journey, it’s your GP. Not only do we get to miss out on quality time with our families, we get to foot the increased electricity and wage bills, too.

So we either do something that results in a real terms pay cut, or we don’t do – and get a real terms pay cut. If you’re in any doubt about what happens when the Government makes life as a frontline health professional intolerable, consider this inner city mantra: “If only I could find an NHS dentist...”

In the meantime, if you fall ill in the daytime run your story past a local pharmacist or, if you’re feeling really brave, call NHS Direct. If they can’t help and say that you need to speak to a doctor, let us know. We all have slots set aside for urgent stuff. We might even be able to sort something out over the telephone.

If you’ve had cystitis before and you’ve obviously got it again, there’s no reason to keep you sitting around crosslegged in my waiting room. Drop off a sample, pick up a prescription.

One last bit of advice. Don’t ring up, exaggerate your symptoms and insist on a home visit to get our attention because we’re fully booked on a busy day. We can spot that a mile off.

It’s a good trick but you can only pull it once, and if you try it again you might find yourself with the added hassle of registering with a new GP. Assuming, of course, that there is still one around to take you on.

Dr Copperfield is an Essex GP. He also writes for www.DoctorPortal.co.uk

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