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At the heart of general practice since 1960

Out-of-hours? Never again, thanks

From Dr Charles Phalp, Stratford upon Avon

From Dr Charles Phalp, Stratford upon Avon

I read Dr Krishna Korlipara's recent views with disbelief. Although out-of-hours co-operatives worked successfully, that was within an envelope of general overwork for GPs. Certainly some co-operatives were successful in providing a good level of care for patients.

But they only provided the participating doctors with relatively better working lives than when they were providing out-of-hours cover for their own practices.The participants traded very frequent out-of-hours cover with a lower call-out rate for less frequent duties with the co-op when the call-out rate was high/unremitting.

Both systems sapped our strength, increased our stress levels and cut into daytime work in the practice and home life too. General practice was dying on its feet because of this. This was the reason our negotiators had a mandate to rid us of out-of-hours and why the Government accepted the change.

To suggest that the only solution is to put the clock back and return to GPs organising out-of-hours co-ops is politically naive and shows how divorced Dr Korlipara is from the opinion of most GPs. The solution is for those PCT co-operatives that are not working well to be properly organised.

Nothing would get me or most GPs I know to work out-of-hours ever again.Dr Korlipara should reflect on whether he is genuinely putting forward a view that is representative of the feelings of most practitioners, or whether he is just trying to promote the National Association of GP Co-operatives to the detriment of the position that our GPC negotiators are trying to hold, against the tide of Government propaganda in this area.

From John Adams, director of clinical standards, Mastercall

As one of the clinical standards directors of Mastercall, providing out-of-hours services for 900,000 patients in Manchester and Stockport, it was interesting to compare the articles by Dr Phil Peverleyand Dr Korlipara.

We are an organisation derived from GP co-operatives and take great pride in our clinical standards. In the last year I have personally audited more than 1,000 randomly selected out-of-hours consultations and I have seen no sign of the kind of consultation Dr Peverley describes.

This may be because we mainly employ experienced local GPs who are happy to work out-of-hours because there is still the co-operative ethos, and because we pay a sessional rate that reflects their skills and experience.

I hope Dr Peverley has made a formal complaint to the provider and his PCT, since this will enable them to take action against this doctor whose performance, at the very least, gives cause for concern.

At Mastercall, such a complaint would lead initially to an in-depth audit of all of the doctor's consultations for the preceding month and a searching interview with one of the medical directors. If the complaint were substantiated, it is likely that the doctor would be suspended from the rota and reported to the performance panel of the relevant PCC.

If he does not complain, and keep on complaining every time one of his patients receives substandard treatment, his PCT will just congratulate themselves on providing a cheap out-of-hours service and publish a glossy annual report showing how wonderful the service is because nobody complains about it. And the same goes for every other GP who is dissatisfied with their out-of-hours provider.

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