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Independents' Day

Out-of-hours mess delays GPs' opt-out

Many GPs will be forced to wait until the December 2004 deadline to ditch out-of-hours work because primary care organisations are struggling to find the cash for the services.

The delays mean PCOs going to the wire before letting GPs opt out ­ and risking teething troubles with untested services at the busiest time of year.

Health minister John Hutton last week announced an extra £28 million to help trusts in England cover out-of-hours, but GPs branded it a 'drop in the ocean'.

Of 19 regions in England, Scotland and Wales contacted by Pulse, five expected GPs to have to wait until December, four predicted a summer opt-out and five were aiming for April. A further five said they had no idea when GPs would be able to opt out.

Dumfries and Galloway NHS board warned taking on out-of-hours responsibility was a 'significant risk area' due to lack of funds.

Dr Gregor Purdie, secretary of Dumfries and Galloway LMC, said the board could only afford two doctors on call to cover vast rural areas and home visits would become impossible. He added: 'That is all the present finances would allow us to have.'

Bolton and North Manchester PCTs said they would not be able to bring in a new service until December.

Dr Andrew Cowie, chair of North West Wiltshire On-Call Co-operative, said local trusts could not afford to take over cover before the deadline. 'None of us believes the money available is going to be sufficient to run a service.'

Dr Tony MacDonnell, chair of Dartford and Gravesham Doctors on Call in Kent, said the local trust would 'leave it until the last moment'. He added: 'GPs will be increasingly unhappy with each extra day they have to wait after April 1.'

Dr Fay Wilson, medical director of Birmingham and District GP Emergency Rooms, said five trusts in the city had a £2 million shortfall in existing budgets to cover out-of-hours.

'Trusts are going to have to spend money from the unified budget,' she said. 'The extra £28 million for England is a drop in the ocean.'

PCOs' deadline to take over out-of-hours is New Year's Eve 2004 but they can go ahead from April.

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