By Gareth Iacobucci
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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