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GPs using out-of-hours as top bargaining tool

Northern Ireland LMCs' annual conference last week heard of growing anger over mounting problems with the new contract – Susan McNulty reports

GPs in Northern Ireland are threatening not to participate in new out-of-hours arrangements in protest at mounting problems implementing the new contract in the province.

The annual conference of Northern Ireland LMCs last week unanimously passed a motion that GPs would withdraw their 'goodwill and participation' in out-of-hours unless primary care organisations agreed 'satisfactory staff budgets'.

LMC representatives also demanded new out-of-hours services be in place by October amid complaints PCOs were dragging their feet over plans to take over.

GPs said out-of-hours was their strongest bargaining chip to force PCOs and the Department of Health and Public Safety to sort out a host of problems with the contract.

On average, GPs in Northern Ireland do more than double the amount of out-of-hours work than the rest of the UK. All GPs are expected to opt out.

Dr David Ross of Eastern LMC, who proposed the motion, said it was a 'wake-

up call' for the department. 'Out-of-hours is the single most important issue,' he said.

'We read about a different scheme every week or that somehow some multidisciplinary team will make everything all right.

'To maintain the goodwill of GPs means that it should not go to the wire of December 31. Departments have know its been coming for over a year. October 1 is not unrealistic.'

Dr Eugene Deeny, chair of Western LMC, said GPs were also encountering problems with enhanced services and other elements of funding.

'This sends a clear message to the department that it must take out-of-hours, and all other elements of the contract, seriously,' he said. 'We have very little [else] in the way of a stick to beat them with.'

GPC chair Dr John Chis-holm said GPs in other areas of the UK may 'go cold' on out-of-hours because of dissatisfaction over other parts of the contract.

'Goodwill from GPs towards PCOs is required to make this contract work,' he said. 'On an individual level there will be a lot of doctors who are less inclined to do out-of-hours work if they feel disaffected on other issues.'

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