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Dr Mary Church: 'Ministers want us to out-of-hours back so they don't get the blame for it'

Dr Mary Church explains the strength of feeling over taking back out-of-hours care.

GPs are absolutely adamant about this. There was extremely strong feeling about not taking out-of-hours back at LMC conference and when I´ve been canvassing opinion locally I get letters back saying “NEVER” in red!

People have short-term memories. When we had responsibility for out-of-hours care it was getting impossible to recruit GPs because of the workload. And out-of-hours is not the same now as it was then. When we had the GP co-ops it was effectively an emergency service. Now patients expect the same level of service as they get during the day. The mindset has changed and we’d be taking responsibility for providing that.

I think the Government want us to take this back so they don’t get the blame for it. And they think it will cost them less as GPs are so cost-effective. They think effectively that we’ll pay for it. I´m sure economics play a part.

All this against a constant background of negative press which is affecting GPs’ plummeting morale. Taking out-of-hours back would adversely affect recruitment. The workload for GPs now in the daytime is so great we just can´t do what we do in the daytime and at night as well.”

We don’t want to go back on this. My father was a GP and I remember him going out in the night in the 50s and 60s and thinking I don’t want to do that.

England needs a system a bit more like the Scottish one which is working well now. But Scotland has had a lot of extra funding.

Dr Mary Church is a GP in Glasgow

Readers' comments (14)

  • thats right mary,out of hours has become no different from in hours.there is no way anybody can provide non emergency treatment 24/7.public expect it and the government encourages it.why doesn't the government and their advisers start laying down some guidelines?sorry,but i do not want to be part of this shambles.god help the ccg's.as the old saying goes-you get what you pay for.i still suggest a token fee for all consultations.

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  • You are absolutely correct , the whole point of this has to do with one thing only ; who is going to pay for it ? responsibility has already been handed over to CCG's in April , so why this nonsense; because it needs to be added to the contract to make one responsible finacially ; once this has happend , we can start paying approx £1000 a month per partner or possibly more. Salaried and locums will be obviously exempt where logically most of the work force is heading anyway; and if the goverment costed OOH at £6000 8 ys ago , you'll be lucky to get peanuts back for it today, so you will be funding a discredited service out of your own pocket and taking the blame for absolutely everything. The only positive note of all this is that in a non distant future, the only way you will get a GP in England is via a locum agency or by private arrangement , because no one will be foolish enought to sign a contract, only then GP's take back control of their lives. Remember , you cannot strike , but you can quit , it is entritrely legal , this is the wonder of being an idependent contractor. Unfortunately for patients, continuity of care will get worst or non existent and by the time most people realise what is happening , it will be too late..

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  • Agree with all of the above - look what happened to the dentists and people's dental health as a result.

    My suspicion is that the DoH wants us all to quit because then they won't be saddled with any pension costs. Who will provide primary care then? Virgin, Tescos etc who may well offer to employ us back at lousy rates. Whatever happens this needs to be played very carefully. Having already accepted the poisoned chalice of commissioning we should not get suckered by "phase 2 " of the evil master-plan to deconstruct the NHS and remove any power from our profession.

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  • As Dr Swinyard's post demonstrates on another page, under the old system Ps has some control and some sanctions against patients who wee unreasonable.
    The problem with what is being suggested, apart from money and workload, is that the doctors will have all the responsibility and be blamed for everything that goes wrong, but precisely no control over how the service is provided. There would be targets for everything which would be impossible to achieve.
    I have had enough of being set up to fail and have no intention whatsoever of being put in this position yet again.

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  • spare a thought for the OOHs GPs who cover the whole of Cardiff single handed

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  • Spot on Mary. Please encourage GPC to resist this tooth and nail.

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  • Have any of you GPs asked your patients whether they would like OOH responsibility to be returned to you. No, because the views of your patients are of no concern to you

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  • No Richard;
    because most patient have no idea how OOH work ( pre and post contract) , neither do you it seems , responsibility has nothing to do with delivery; patients are fooled by headlines (as yourself) that they will see their own GP OOH who knows them well , this will simply not happened for the same reason you don't work 24/7. so please stop your nonsense , the reason why GP's and I are against it , is that we don't want to be responsible for something we will not control or deliver but will most likely pay for sinking further primary care funding.

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  • It is now easier to see the Pope than my GP and everyone forgets how the DoH slipped up when they allowed the then GP practices to opt out!

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  • Neil Jessop,
    So Neil, how did your last audience with the Pope go.
    I have often wondered what it is like.

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