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At the heart of general practice since 1960

Massive out-of-hours opt-out would threaten GPs' future

Dr Adrian Midgley and colleagues (Letter, February 10) seem to have taken offence at my prediction that setting the cost to opt out of out-of-hours care at £4,000 will lead to most, if not all, of the GP workforce voting with their feet.

My comments were merely a statement of fact: the remuneration in the current GMS contract that nominally covers out-of-hours services does not reflect the true cost of providing the service which, in Leicestershire and Rutland, could amount to around £24,000 per GP per annum. So there would be a shortfall of some £20,000 per GP per annum that would have to be met by the PCT.

So far there is no indication that there are additional central funds that would be available to cover this cost, so it would have to be met from existing PCT budgets. In other words, if all 61 GPs in our co-operative decided to opt out of out-of-hours care, the PCT could be facing a bill of £1.22 million.

As our co-operative does not cover all GPs in our PCT this figure should be regarded as conservative. It does not take much to realise that such figures replicated across the whole of the country would have huge financial consequences for the future of general practice and, as a result, the opt-out price may not be as low as many would hope. GPs may feel justifiably aggrieved by this state of affairs but it exists nonetheless.

Dr Philip Rathbone

Chair of Melton,

Rutland & Harborough Doctors On Call

Long Clawson

Melton Mowbray

Leicestershire

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