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Rural GPs demand extra out-of-hours funds in contract

Rural GP co-operatives have warned they face a host of problems if all GPs give up on out-of-hours services under the new contract unless the Government funds rural care adequately.

GPs warned the low price of £4,000 likely to be put on out-of-hours services left them no incentive to retain 24-hour responsibility, yet they could not cash in on high rates of locum pay likely to be offered to urban colleagues.

Primary care trusts struggling to meet the prohibitive cost of rural out-of-hours care were unlikely to be able to pay locums a market rate for the job, they said.

Rural GPs fear they will also end up picking up the pieces of out-of-hours care regardless, because the trust has no viable alternative.

Dr Jim Edwards, chair of Dorset Doctors on Call and a GP in Sturminster Newton, said poor funding could result in GPs being swamped with work during the day or being forced to work more shifts than they wanted to.

'We are concerned about what happens to our patients out-of-hours. If the work is not to the same standard then

it just makes more work for us during the day. Unless it's

properly funded it will cause

a lot of discontentment,' he added.

Dr David Jenner, NHS Alliance spokesman for GPs on primary care trust professional executive committees, said the contract was unlikely to take account of rural needs because the Carson report found no evidence that services cost more in remote parts.

Dr David Watts, chief executive of Ayrshire Doctors on Call and a GP in Dundonald, predicted out-of-hours provision under the new contract would cost the Government an extra £150 million a year.

GPC joint-deputy chair Dr Hamish Meldrum said the GPC and the Government were aware that re-provision would 'cost more in certain

areas'.

He added: 'How the Government solves that is to some extent their issue.'

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