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GPs likely to take on out-of-hours care themselves, says Lansley
22 Jun 10
Health secretary Andrew Lansley has said he expects many GPs to provide out-of-hours services themselves under the Government’s controversial commissioning plans.
Mr Lansley responded to the GMC’s decision to erase German out-of-hours locum Dr Daniel Ubani from the medical register with his strongest indication yet that GPs might end up becoming providers of last resort under the new system.
His words will heighten growing tensions in the profession, following the backlash that has followed the knife-edge vote at the LMCs conference, where GPs narrowly voted in favour of taking a ‘central role’ in commissioning out-of-hours services.
Dr Phil Garnett of North Yorkshire LMC - among 48% of representatives who opposed the out-of-hours motion – was among those to condemn the decision, saying it was a ‘poisoned chalice - turkeys voting for Christmas’.
GP leaders responded to those concerns by vowing to fight any move from ministers to make it a core responsibility for all GPs to commission out of hours services.
But Mr Lansley’s words have raised fresh concerns that the Government’s policy will push GPs closer towards a return to round-the-clock responsibility.
Mr Lansley said: ‘There is no doubt that out-of-hours care needs urgent reform. GPs are best placed to ensure patients get the care they need, when they need it.
‘If GPs are responsible for commissioning out-of-hours care, I believe many will also decide to play an enhanced role in providing these services themselves.’
But the GPC insisted practices should be able to choose their level of involvement in commissioning out-of-hours care, with some option for full responsibility and others a more peripheral involvement.
Dr Nigel Watson, chair of the GPC’s commissioning and service development subcommittee, told Pulse a ‘central role’ did not mean ‘having to sort it out’.
'Some GPs may take several leaps further than others. Some may want to provide out-of-hours as well as commission it. Others may be satisfied with an involvement in tendering or in monitoring care.
'The Government has indicated it wants to rewrite the GP contract to include commissioning. It makes sense for GPs to be responsible for funding they consume, but we would not want it imposed.’
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Readers' comments
The thin end of the wedge is coming.... beware ! OOH is hurtling towards us and a lot of us will be sitting ducks although we don't want to be providing any of it.
COMMISSIONING CARE FOR OUT OF HOURS WILL HAVE TO DEAL WITH CARSON CRITERIAS IT NEEDS LARGER NUMBER OF PRACTICES TO DELIVER THE STANDARDS.INDIVIDUAL PRACTICES WILL NOT BE ABLE TO CONFORM.
The Health Secretary in his infinite wisdom could of course scrap the requirement to meet the Carson Standards.
This is a tragedy. We ran and willing worked for excellent co-operatives which were cast aside by a Labour government bent on doctor-bashing. Our work was so under-valued I doubt any of us possess the energy or enthusiasm to re-establish services let alone reliquish our stress free nights and week-ends. We should not accept this without gold plated remuneration.
We should not accept this under ANY circumstances, and I hope our generally useless leaders will at least fight for this after selling our souls for the 2004 contract.
The 2004 contract was a fair deal; the political machinations since have made it an unfairly implemented deal, not an unfair deal. Nobody leading the profession can "force" or "impose" conditions on an elected government, so let us get real about what we expect from our GP leaders; let us accept the fundamental nature of parliamentary politics and economic forces. If we can stop bickering amongst ourselves, agree a service delivery and remuneration that is equitable (yet not identical,) varied to meet individual circumstances (but not exploitative of individuals) and proportionate to the effort we put in then we have a chance to become the trusted sensible voice of the british public that the politicians fear and wish to destroy to protect their monopoly of control of state power.
Actually it is the patients who consume the funding not us GPs. Ergo make the patients accountable for funding?! Mr Lansley seems as stupid as his predecessors. God help us all.
I hope Mr Lansley is prepared for the same kind of GP recruitment crisis pre GMS2. It seems some of our GP leaders have short memories judging by the lack of opposition to the health secretary's plans. 2004 wasn't that long ago for god sake. For such a "safety critical job" how can it be even remotely acceptable for GP's to provide cover around the clock. We are all human, and have basic limits of endurance no different form the very public we serve. If the public really want to be treated by a decreasing workforce of exhausted, and ultimately, unsafe Dr's then I guess Mr Lansley is on the right track. I hope for his sake, the lives of his nearest and dearest dont rest in the hands of an overworked GP, too tired to keep his eyes open, let alone make safety critical decisions. Only then may he see the real effects on patient care, caused through the sheer stupidity of his policies.