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Start pestering PCOs if you want to drop out-of-hours

The GPC has spelled out what GPs should do if they want an early exit from out-of-hours work under the new contract.

GP negotiators said GPs should start putting pressure on PCOs 'as soon as possible' if the contract was accepted. Practices should also use the issue to trade with their PCO over the services managers want GPs to provide.

Dr Andrew Dearden, chair of GPC Wales, said if trusts were unwilling to help GPs transfer out-of-hours responsibility earlier than next year, they should lobby their strategic health authorities or equivalents to complain about lack of action.

'If you have a stroppy PCO, write to them and remind them that if they are the last one to let GPs opt out, they may not be able to recruit anyone next year and older GPs will probably then think about resigning,' he said.

'Then write to the strategic health authority in England or the Assembly in Wales and so on, and say this is an important part of the contract and this PCO seems completely unwilling to do it,' he added.

GPs cannot give up their legal responsibilty for out-of-hours until April 2004 when new primary legislation comes into force. But PCOs can agree to take over earlier.

Dr Dearden said GPs should not be afraid to bargain with PCOs: 'They are going to need GPs' help with certain things, and there are also things GPs want and one of these is giving up out-of-hours. I hope the days of the timid GP waiting for the PCO to bless them with money are over. We really need them to recognise it's not just PCOs now bestowing gifts.'

Dr Tony MacDonnell, chair of Dartford and Gravesham Doctors on Call, said it would be difficult for GPs to opt out this year unless any model 'had the vigorous support of the PCT'.

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