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GPs should take back out-of-hours responsibility, says health secretary

Health secretary Jeremy Hunt has given his clearest indication yet that he expects GPs to take back responsibility for running out-of-hours services.

Speaking on the BBC’s Politics Show yesterday, Mr Hunt said: ‘I think we need to go back to GPs having responsibility for making sure that for the people on their list there is a good service available.

‘I think the reforms we’ve had in the health service help to make that happen but there’s a lot more we need to do.’

Mr Hunt said he would ‘never blame GPs’ who he said ‘work extremely hard’ and that he would not expect them to provide the services themselves.

‘I don’t want to go back to the days of GPs personally being on call at two o’clock on a Saturday morning,’ he said.

But he reiterated that he believes contract changes in 2004 to allow GPs to opt out of running out-of-hours services have caused problems.

‘I do think that contract is to blame yes – when you removed the responsibility for running those services in the evenings and weekends the service deteriorated and there was a great loss of public confidence.’

He added: ‘If you need to speak to a GP out of hours you will generally get someone a very long way from you who doesn’t know you, can’t see your medical notes.’

Dr Agnelo Fernandes, the RCGP’s urgent care lead who sits on NHS England’s Emergency Care Review, told Pulse last week that Mr Hunt was wrong to blame GPs for the crisis in A&E departments, as attendance figures remained flat over the decade since the new contract.

The latest NHS England figures show that while A&E performance ‘deteriorated significantly’ in the last quarter of 2012/13, attendance figures were 1.7% lower year-on-year.

On the back of the figures, GPC deputy chair Dr Richard Vautrey has called for Mr Hunt to apologise. On the social networking site Twitter, Dr Vautrey said: ‘Clear facts about A&E figures. Time for a Government apology to GPs.’

Dr Steve Kell, co-chair of NHS Clinical Commissioners’ Leadership Group and chair of Bassetlaw CCG, said that he had growing concerns about the media ‘firestorm’ was affecting the implementation of the Goverment’s NHS reforms.

He said: ‘There is little doubt that a fire-storm has being whipped up over what is happening in A&E departments, with primary care provision, the GP contract and out-of-hours care being dragged into the mix.

‘NHS Clinical Commissioners role is to speak for local commissioners, but as membership organisations we recognise that the morale of GPs is fundamental to how CCGs can operate.

‘After all, if GPs are feeling squashed by their workload they are going to be far less able and willing to then engage on top of that with the commissioning agenda. CCGs need the foundations of strong general practice upon which to build.’

Readers' comments (24)

  • ya right , ooh ... there so its going to be 24/7 oncall 7 days a week, take a hike will be my answer .. here i come oz ...
    most of gps near retirement age will retire and younger ones will move away and best of luck to the government getting new graduates into general practice..

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  • I don't think you will here a lot from the silent majorty of gps who will quiety disappear as above. Then the fun will start for the rest of us ! They can pass it back but just doing it as we offer no resitance ,organized or not to change and say we can contract it out but as we have resposibility when the provider cannot provide as there is no one to do the work because thay have all vanished it will default back to us on a Friday at 1830 !

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  • Vinci Ho

    Agent Hunt is on the way of promotion to the top.
    He is trying to use his 'charm' to talk like a kind human being on one hand and he has got a gang of 'body guards' who are willing to fire all kinds of cylinders with no feelings on the other hand. It is like playing bridge.
    It is interesting that the Health Secretary instead of anyone else would come out to face the media on the row about gay marriage . You know what , do not rule out the possibility of agent Hunt becoming the Tory leader and hence the PM!!!!!!

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  • I think I would definitely have to emigrate if that was the case !

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  • It is time for our nominated leaders (especially the BMA) to stand up in the media and say why this proposal is nonsense!

    Mr Hunt has said that he does not envisage GPs doing home visits themselves in the early hours of the morning but does think that having OOH is best done by GPs with access to the patients' records.

    The truth is no one has access to the patients' records EXCEPT the registered GP.

    I may know more about local services in North London than a GP in another part of the country but I don't know any more about my neighboring practices' patients than anyone else.

    Using Mr Hunt's reasoning effective OOH care would only really be effective by the patients' own registered doctors. This doesn't square with him saying claiming to understand that we are at full capacity at present and cannot do additional work to 12 hour days.

    If this comes to pass and our daytime workload remains the same we can forget about an exodus of GPs.... the bigger problem will be mistakes born out of fatigue and inevitable patient harm!!

    This is not an issue for threats of strike... this is an issue that should lead to mass resignation.

    If this is not our "line in the sand" nothing else ever will be!!

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  • If this is forced upon (and I suspect it would be in one shape or the other), then I will leave the country. Even if he double my income, it's not worth the money as there is no way I'll be able to hire anyone else to share this workload - who would want to work 70hrs+ at night time and weekends at 90k/year (bearing in mind over 10% of which will disappear on neccesary costs including medical indemnity, GMC, courses locum insurance etc).

    I'm not young enough to be able to move without hussle but not old enough to be able to retire so only way is emigration.

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  • Vinci Ho

    For those who share my belief that the truth cannot be condemned to a lie , a lie cannot be disguised as the truth , please watch ' Hillsborough- How they buried the Truth ' tonight BBC 1 Panorama 9:00 PM

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  • Anonymous | 20 May 2013 3:14pm

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  • Anonymous | 20 May 2013 3:14pm
    Another alternative would be for the OOH GPs to be able to access the patient's clinical record.

    Given the work being done now to enable patients to access their own record, that doesn't seem too far a leap.

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  • I think the main problem is that the trust required between the DofH and GP profession has been eroded considerably by their contract impositions and PR onslaught. Even if they offered a fair deal for GPs to take back responsibility for OOH work the whole profession is aware the DofH will move the goalposts at the earliest opportunity.

    Look for a well funded but enforced deal followed by years of political interference, increasing access, drumming up workload and below inflation funding increases.

    What needs to happen is a crazy rethink, such as no OOH care except those under specialist palliative care. The funding saved can be reinvested to A+E departments to hire staff (?GPs) who can see and d/c patients without insisting everyone has bloods and a CXR and the final measure of a small (10 pound in hours, 20 pound ooh) charge for attending A+E.

    Problem solved, except it would be political suicide.

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