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At the heart of general practice since 1960

Seven in ten GPs would not take back out-of-hours 'at any price'

Exclusive Most GPs would not take back responsibility for out-of-hours care even if they were offered up to £20,000 per partner and had a guarantee they would not have to do the on-call shifts themselves, a Pulse survey reveals.

The survey of 400 GPs reveals the extent of the opposition in the profession to resuming any kind of responsibility for out-of-hours care, with 62% saying they would support the GPC in taking some form of industrial action if NHS England seeks to change the GP contract to do this.

The survey also found considerable opposition to RCGP proposals that the profession considers taking back responsibility for the out-of-hours care for the 5% of vulnerable patients on their lists – with 87% opposed to the idea.

Half of GPs said they would still reject taking back responsibility for overseeing the quality of OOH care for their patients, even if there was a guarantee they did not have to do on-call shifts themselves – 36% were in favour.

Some 69% of GPs said they would not take back responsibility for out-of-hours care ‘at any price’, although 23% said they would do so for £20,000 per partner annually and 5% said it would take £10,000 annually for them to change their minds.

The strength of the opposition is likely to prove problematic for the GPC, who have recently been hinting that they may agree to co-operatives of GPs resuming out-of-hours responsibility for patients.

The GPC recently dropped its opposition to RCGP proposals for GPs to resume responsibility for the 24/7 care of elderly patients or those with complex medical problems, after the college clarified the proposal would be for GPs working in federations or co-operatives to take collective responsibility.

The furore over out-of-hours care was sparked by health secretary Jeremy Hunt last month when he announced that he wanted GPs to be individually responsible for their patients around the clock and given a duty to ‘sign off’ out-of-hours care.

LMC leaders last month rejected the possibility of GPs taking personal responsibility for out-of-hours care at their annual conference, and grassroots GPs taking the Pulse survey went further, saying any kind of extra responsibility should be rejected.

Dr Mark Beecham, a GP in Maldon, Essex said: ‘Definitely not. It would be the thin end of the wedge.’

Another respondent Dr Thomas Bloch, a GP in Broadway, Worcestershire said this would mean practitioners getting the blame for problems: ‘This would be a recipe for disaster - we would get the blame for any shortcomings. This is the only reason the Government wants to be shot of it.”

Responding to the survey, Dr Mary Church, a GP in Blantyre, south Lanarkshire said: ‘This is an over my dead body issue.’

Dr Richard Vautrey, GPC deputy chair, said the survey showed that contractural changes were not required as CCGs now had responsibility for out-of-hours care.

He said: ‘GPs are fearful that this would place a contractual change upon their shoulders and those who say it´s the thin end of the wedge are right.

‘We need to be very careful about any attempt to increase the weight of responsibility on GPs and we don´t want to complicate commissioning arrangements via CCGs by doing so at a time when CCGs are just getting started.’

Dr Vautrey also said that ‘no-one is threatening’ industrial action. However, he added: ‘If the Government is mad enough to go down that road, industrial action would be the least of their worries. GPs would vote with their feet and leave the profession and then you´d have a crisis in in-hours care as well.’

In full: Results of GP survey on out-of-hours care 

Related images

  • out of hours september 08   3  N

Readers' comments (34)

  • industrial action is empty threat and have never worked in last 30 years. when it will be imposed and finance would be at stake, every one will find alternative.
    money makes the world go round. same will apply here.
    give enough money to hire ooh care and all will work. some one need to tell us cost of ooh though.

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  • Peter Swinyard

    Some paragraphs quoted from 1935 Medical Card given to me when a patient registered in the late 1990's: "An insured person in receipt of Medical Benefit is required to comply with the following rules as to conduct:
    [b] he shall obey the instructions of the practitioner attending him
    [c] he shall not conduct himself in a manner which is likely to retard his recovery
    [d] he shall not make unreasonable demands upon the professional services of the practitioner attending him
    [e] he shall whenever his condition permits attend at the surgery or place of residence of the practitioner on such days and at such hours as may be appointed by the practitioner
    [f] HE SHALL NOT SUMMON THE PRACTITIONER TO VISIT HIM BETWEEN THE HOURS OF 8PM AND 8AM EXCEPT IN CASES OF SERIOUS EMERGENCY
    The Rules of The Committee also provide that any complaint by an insured person which is adjudged by them to be frivolous or vexatious shall be regarded as a breach of their Rules.
    It goes on to say that breaching the rules incurs a fine on the patient of not exceeding 10s or in case of repeated breaches 20s or be suspended from medical benefit for a period not exceeding a year.

    So that is why out of hours used not to be a problem- fine a man a week's wages for calling the doctor out or even remove entitlement to medical care for a year. How life has changed in living memory (these rules were written when my mother was 10. )

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  • Anonymous | 14 June 2013 4:04pm

    so why does not nhs england organize it.

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  • industrial action is a non starter as we are in breach of contract the only option is resignation we will still see patients but for a fee say £50 for 15 mins those that dont want to pay can go to see those wonderful A&E doctors we hear so much about the government would climb down in days

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  • This comment has been deleted by the moderator.

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  • its interesting that we all keep going on about industrial action when everyone knows that when the government calls our bluff (if they ever do), few if any of us will actually strike. Mostly because we, unlike the health secretary and his colleagues and contrary to the daily wail, actually give a damm about our patients and their wellbeing. Still think resignation would be the only way to go.

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  • yay for living in scotland....!

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  • Whatever happened to the Hippocratic Oath?

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  • above-thats the problem, we care for our patients too much. If only they cared about us.
    thanks mr daily mail

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  • hippocratic oath doesnt mention free medicine, also applys in australia canada south africa usa ireland etc all of whom charge,and all of whom crying out for british qualified GPs,i regret coming back from australia 20yrs ago worst mistake of my life

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