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LMCs reject plan to hand responsibility for out-of-hours care back to GPs

LMC leaders have rejected Jeremy Hunt’s call for GPs to resume round-the-clock responsibility for patient care - but have also rejected a motion of no confidence in the health secretary.

Delegates queued up to offer strongly worded objections to a motion proposed by sessional doctors subcommittee chair Dr Malcolm Kendrick which suggested that, given certain guarantees, GPs would be willing to resume responsibility for out-of-hours care. The motion was overwhelmingly rejected, with just one delegate voting in favour.

In opening the debate, GPC chair Dr Laurence Buckman said that the health secretary treating out-of-hours care ‘as a political football’ was not helpful but he urged GPs to look at what in his proposals they may be able to work with.

He said: ‘There were a number of things Mr Hunt said that I didn’t like and I don’t think you did either but I think we should look at what we cold work with.’

‘The devil is in the detail, but sign-off may be something that we could develop for the benefit of our patients.’

‘I laid down some lines in the sand yesterday in my opening speech when I said GPs won’t shore up urgent care. It appears Mr Hunt now agrees as he said he does not think GPs should constantly be on call.’

He reminded delegates that if they rejected the motion existing policy - that GPs do not accept out-of-hours responsibility, would still stand.

But after numerous speaker interventions and points of order, a separate motion proposed by Bedfordshire and Hertfordshire LMC which went further and explicitly instructed GPC to ‘oppose any proposition for GPs to take back responsibility for the organisation of out-of-hours services’ was not put to a vote.

GPs repeatedly expressed concern about the impact of the profession taking back responsibility.

One sessional subcommittee member said: ‘This motion does not have the full backing of the sessional doctors’ committee. If we take it back there is no way we could agree funding or agree that private companies do not get involved. If my husband thought I was in favour of this he would never speak to me again. Over my dead body.’

Another delegate said: ‘There would be so many GP resignations that general practice would collapse.’

Dr John Reynolds, from Derbyshire LMC said: ‘De facto, CCGs are now responsible for out of hours. We don’t need to change our policy.’

However, despite expressing strong criticism of his policies, the conference delegates narrowly voted against a motion declaring that GPs have lost confidence in health secretary Jeremy Hunt. In a close vote, which had to be concluded electronically, 40% of GPs wanted to pass the motion but 60% were against.

Dr David Wrigley, GPC member, who proposed the motion, said: ‘I have no confidence in Jeremy Hunt because he constantly undermines the NHS and denigrates doctors. Jeremy Hunt has been in place for just nine months and already he has proved to be the worst health secretary ever. He tweets like a teenager and said four million extra people were presenting at A&E, but he failed to mention that three million of these are to new walk in centres.’

But Dr Alan Mills from Cambridgeshire said: ‘There is time when less is more. It demeans our profession to stoop to personal attack. I think we have other, better things to do.’

LMCs also voted in favour of an emergency motion which said that GPs are the patients’ champions, that NHS staff is working harder than ever and that the targets and requirements of QOF, QP and enhanced services are getting in the way of dealing with patients.