LMC leaders dodge key out-of-hours vote

By Steve Nowottny

GP leaders in Scotland have voted unanimously against a return to compulsory out-of-hours work - but dodged a crucial vote on whether practices should take back commissioning responsibility.

A fierce debate at the Scottish LMCs conference in Glasgow displayed the huge division within the profession over the looming question of whether responsibility should be handed back to GPs.

The Conservative party has pledged to make responsibility for commissioning out-of-hours care part of the core GP contract in England if it wins the general election - although GPC chair Dr Laurence Buckman has said negotiators would oppose any contractual renegotiation.

Delegates swiftly passed a motion insisting 'there will be no return to compulsory out-of-hours work', but were divided over a second motion that the conference 'rejects the idea floated by some parties to hand back out-of-hours patient care responsibility to GPs and reminds Scottish Government that it is neither safe for the patient nor for the GPs.'

Dr Arun Rai, a GP in Clydebank, Glasgow, said: 'This happens whenever there is any tragedy in out-of-hours care. The quality of care for most people is better than it was in 2004.'

'We do not want to return to a 24 hour commitment and personal responsibility for out-of-hours GP cover.'

Tayside LMC's Dr Mary O'Brien added: 'If we take back out-of-hours care we're going to take back a whole lot of problems.'

But Dr Sebastian Pflanz, a GP in Dalbeattie in Dumfries and Galloway, was one of several to argue that GPs would be better placed as commissioners of out-of-hours care.

'SInce its inception NHS 24 has come under scathing attack from GPs,' he said. 'The suggestion was that GPs could do it better - and I believe that's right.'

However delegates declined to vote on the issue, after complaints that the motion was badly worded and confused responsibility for commissioning and for provision.

GPC chair Dr Dean Marshall described the conference's failure to agree a policy on the issue as 'unfortunate' - but added that the prospect of a return to responsibility for out-of-hours care in Scotland was less imminent than in England.

'There isn't any political party in Scotland that I'm aware is suggesting it,' he said.

Check out our blog from the conference: Scottish LMCs conference: As it happened