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Six in ten GPs 'could resign' over out-of-hours proposals

Exclusive Six out of ten GPs would consider resigning if the Government forces GPs to take back out-of-hours responsibility, a survey of hundreds of grassroots GPs reveals - and an overwhelming majority believe the GPC should make it clear such proposals are ‘unacceptable’ without waiting for further detail to emerge.

The snapshot poll of almost 450 GPs, seen by Pulse, was commissioned by Bedfordshire and Hertfordshire LMC early last week following press reports trailing health secretary Jeremy Hunt’s speech, in which he suggested that the GP contract would have to be changed to hand back responsibility for patients’ out-of-hours care to general practice.

The survey is the first to examine how GPs could respond to Mr Hunt’s proposed changes, and the strongest indication yet of the depth of feeling among grassroots doctors. It follows a stormy debate at the LMCs conference on Friday, where delegates voted against a motion calling for out-of-hours responsibility to be transferred back to GPs but stopped short of formulating a response on behalf of the profession.

The chief executive of Bedfordshire and Hertfordshire LMC, Dr Peter Graves, told Pulse that the survey’s findings were particularly alarming because 67% of respondents said they were at the start or in the middle of their career.

The survey asked the question: ‘If the Government imposes a change on GP surgeries so that they have to stay open and have responsibility for out of hours, how would you respond?’

Of the 397 respondents who answered that question, 63% said they would resign or retire. A further 36% said they would ‘accept the change unwillingly’, while just seven GPs said they would welcome the change.

There was also an overwhelming majority of GPs - 85% - who said the GPC should make it clear that Mr Hunt’s proposals were ‘unacceptable to GPs’ even before any further detail is revealed.

Dr Jeremy Cox, a member of Bedfordshire and Hertfordshire LMC, said: ‘The survey response was quite remarkable. We have never seen anything like the torrent of responses.’

‘There was a huge amount of emotive stuff about how this made them feel…. Grassroots GPs just don’t want this to happen. They’ll walk.’

‘The young GPs said they would go to other specialties. It’s really upsetting. One young GP said she was at the end of the tether. This would finish her off – she’d leave.’

A separate survey conducted by East Sussex LMC found that 93% of the 484 GPs surveyed said it would support the GPC in opposing any proposition for GPs to take back any out-of-hours responsibilities.

An NHS England spokesperson said: ‘No one is suggesting that GPs go back to personally being on call evenings and weekends.

‘We support the principle of general practice having greater responsibility for the quality of out of hours care that their patients receive.

‘We want to work with the profession to agree how best to put these principles into practice, building on the steps that CCGs are already starting to take to improve out-of-hours services through their new commissioning responsibilities.’

Survey results

What is your GP status?

Partner - 364

Salaried - 42

Locum - 25

Trainee - 7

 

Where are you in your career?

At the start - 95

In the middle - 205

Towards the end - 147

 

If the Government imposes a change on GP surgeries so that they have to stay open longer and have responsibility for out of hours, how would you respond?

Resign or retire - 247

Accept the change unwillingly - 143

Welcome the change - 7

 

As there are no details given in Mr Hunt’s proposals at the moment, how do you thing the GPC should be responding right now?

Wait for more details before making a response - 67

Make it clear now that such proposals are unacceptable to GPs - 367

 

Source: Bedfordshire and Hertfordshire LMC

 

Readers' comments (35)

  • Get THE DAILY MAIL to take responsibility for OOH after all with their collective genius, they should have no trouble!!!!

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  • Quote from Jeremy Hunt's speech:
    "No one is suggesting that GPs should go back to being personally on call during the evenings or weekends - they work hard, they have families and they need a life too. But should the quality of out of hours care for people on their list really have nothing to do with a GP? And is it right that most out of hours providers can’t even access your medical record even with permission?"

    As ever the devil will be in the detail but important not to dismiss any change based on the misunderstanding that this would be a return to pre 2004 around the clock care. Sounds more like a GP collective with access to member practices' patient records.

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  • I really cannot see any female colleague of mine taking on OOH.The 'industry, this is what GP is all about these day, will be predominanlty female driven in next few years,
    Teh DH of seems to lack insight into the real problem and its responsibility to the public.
    I will be hanging my boots up iminently. I and other colleagues are battered by DH spin, accusation, insinuations and lack Duty of Care to its workers.
    Mr Hunt can carry on........

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  • What we all have to realise is that a large number of GPs have already resigned, like me.
    However, there is a 6 month time lag until it is noticed as partners have to give 6 months notice. See what happens in 6 months time!

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  • Before 2004, our faces were in the mud and DH had its boot on the back of our neck. We've lifted our heads now - we can see the weekend (and enjoy it)!
    Do they really think that we're going to lie back down in the mud meekly and go back to the 168 hour week - no life before retirement?
    Of course you can get a locum in or spread the work around a collective. That was always an option before 2004. Lifting responsibility lifted an enormous burden. I can't see any reason to take that burden back, until DoH stops bashing everyone else but themselves.

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  • When the GP staffing crisis (which has already started) gets into full swing-remember the names DAILY MAIL and Jeremy hunt. They will deny the damage they have done, of course. By then Jeremy Hunt will be MP for Sport or some other nonsense and only have a hazy recollection of past events. There will be stories of medical students and trainees being pressurised into doing a career in General Practice against their will. The newspapers will call medical students lazy and evil unless they capitulate into a career of abuse and subject to thuggery. Arguments will break out over who brought GP down to collapse. The government will step in and start offering free book tokens to any trainee who commits to a lifetime of media threats and The Daily Mail will have a campaign to "bring back the medical students of the 1950s" and start slagging them off.

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  • GPs no longer have a list.
    Patients are registered at a practice now-just what the government wanted in order to break the link between the doctor and the patient.
    Bit rich now to want YOUR doctor to be responsible for your care OOH.

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  • I don't buy it.There is a world of difference between "could" and "will" and besides we already know GPs are good at spouting hot air.Also surveys such as these are biased anyway inviting responses from mainly the disgruntled bunch.

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  • Another issue that has to be considered is the relative stress in being an OOH GP compared with the same hours in a hospital environment. In hospital you have a team of people including medical colleagues to discuss cases with, nurses to support you and a full back up of equipment and investigations.
    In general practice you are alone, with no-one to support you, no diagnostics and no back up. You are also likely to be travelling to patients' houses in the middle of the night which makes things more difficult. I remember it well, and it simply is not the same as a hospital shift in AE. If his happens there needs to be an honest debate with public about what can be provided, and it will not be a 24 hour AE service in your own home!

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  • Taking back the responsibility means just that..not actually doing the OOH yourself. There will be restrictions on hours worked over a week by a doctor anyway as any commissioner of OOH should already know. the NHS has to get a grip of the crisis in A&E and their root cause analysis (RCA) takes them to the dropping of OOH by GPs, which is a fair assessment. No one looked forward and calculated the risks around allowing GPs to surrender their 24 hr responsibility. The GPs were at the time delighted to give up 6K or whatever it was at the time, knowing they were worth far more but accepting the offer. Could a =n OOH be provider for 6K a GP? Of course not! And further more the knock on effect of reduced continuity of care and increased NEL admissions wasn't factored in either-hence crisis in acute care. Also, and I'm not sure if I dare say this, the quality of holistic E of L care in the community meant that there was probably more TLC around very frail elderly and people being more likely to die earlier-this change has resulted in additional frail elderly blocking acute beds and increased nursing home need when the alternative was a comfortable death at home with a loving family around you.
    By GPs taking back responsibility of OOH they might be able to reverse some of the medicalisation of old age

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