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CAMHS won't see you now

Jettisoning out-of-hours will cost us our independence

GPs should not opt out of out-of-hours, although they can still give up actually doing it. We should keep the service in house and set up our own providers or keep contracts with co-operatives or deputising services.

Although this may be more expensive in the first year, GPs will pay heavily in following years if we let PCTs take over. If we opt out we will be setting up direct competition for our services and let money flow away from direct care of patients.

Already PCTs are entering contracts with providers for helping with in-hours services, such as flu immunisations and meeting 48-hour access targets, sometimes by using our enhanced services monies. That is only the start. We will be left with chronic disease management and feeding the NHS computer.

Dacorum PCT is being given £800,000 to provide, one way or another, for an out-of-hours service. The Government has succeeded, for this tiny sum, in nationalising general practice for the bulk of the week. The PCT will be in charge of our patients and caring for them all over the weekends and every night ­ more than double the hours we will be contracted to cover. That service will grow like Topsy.

By hanging on to out-of-hours GPs can help ensure that any add-on service the PCT wants to purchase has to come from the local GPs. A GP-owned provider could be a locus for diagnostic, treatment and walk-in services. We need to ensure we remain in charge of our own destiny. Do not opt out.

Dr Gerard Bulger



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