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Out of hours GP services condemned as a 'shambles'
Last updated at 10:22am on 14.03.07
The shake-up of out-of-hours GP services have left ill patients battling to find proper NHS care
The shake-up of out-of-hours GP services was condemned as a 'shambles' yesterday.
Patients who become ill at night or weekends have been left battling to find proper NHS care since GPs handed over responsibility to primary care trusts.
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Only one in 50 services is meeting the performance targets set to ensure patients get proper advice and treatment.
The result, according to a damning report from MPs, is that patients have been left worse off.
Primary Care Trusts - The Results
Only doctors have 'done well' out of the deal, it says. Confusion over availability of out- of-hours services has also resulted in a ten per cent increase in emergency calls for ambulances in the past year.
More patients, simply unsure where to turn, are arriving at hospital A&E departments.
The report, from the influential Commons Public Accounts Committee, says the Health Department took a back seat in negotiations over the new system that allowed GPs to stop working unsocial hours in return for relatively small pay cut of £6,000.
Although the service introduced three years ago is now starting to improve, the performance of trusts against key targets is 'still not good enough', it says.
Just 2 per cent of services comply with standards such as answering calls promptly.
The shake-up of out-of-hours GP services have left ill patients battling to find proper NHS care
The report follows concern over pay deals struck by the Health Department which have seen GPs' pay break the £100,000 barrier.
The report also reveals soaring costs took the shake-up £70 million over budget - at a time when the NHS is axing jobs and patient services to save money.
Before April 2004, GPs were responsible for out- of-hours patient care - between 6.30pm and 8am on weekdays and 24 hours at weekends and bank holidays.
Now primary care trusts are responsible for around nine million patients receiving care out of hours in England each year.
These services are provided by a range of organisations, including in-house trust teams, GP cooperatives and private companies.
But they have been plagued with problems from the start, with patients complaining of delays and disorganisation.
One service came to prominence last year during the inquest into the death of Penny Campbell, a 41-year-old journalist from North London, who died of multiple organ failure in 2005.
In the four days leading up to her death, she had six telephone consultations and two face-to-face meetings with doctors working for the service Camidoc.
A coroner ruled that the doctors she saw contributed to her death by failing to recognise the seriousness of her illness. The PCT and Camidoc are undertaking a review.
The Public Accounts Committee chairman Edward Leigh, Tory MP for Gainsborough, said the new system had increased financial pressure within the NHS and the Department had failed to get value for money for the taxpayer.
Costs have risen from the original estimate of £322 million to £392 million a year.
The cross-party committee's report said: "We found that preparations for the new service were shambolic, both at the national and local level.
"The department took part in the negotiation of the new General Medical Services contract only as an observer, and only the doctors did well out of the deal on out- of-hours costs."
Mr Leigh added: "The new service is getting better. But the needs of patients are not best served by the ending of Saturday morning surgeries.
"They are not best served where access to advice and treatment is often extremely difficult and slow."
Joyce Robins, co-director of Patient Concern, said: "It's a muddle. Patients have no idea what the service is supposed to be doing so they end up going to A&E."
Dr Hamish Meldrum, chairman of the British Medical Association's GPs' Committee, denied family doctors had benefited at the expense of patients.
"We would reject the implication that GPs were the only ones to do well out of this deal and that the Government was not really involved. Family doctors had been taken advantage of for years, working long hours on the cheap."
A spokesman for the Department of Health said: "We are aware that some areas face more challenges than others, including in very rural and very urban areas, and we are determined to ensure that out-of-hours services in every area match the standards of the best."
Reader views (5)
I needed the Lambeth out of hours service over Christmas and New Year. They were excellent. It was a bit of trek to get to by bus from where I live but it was a lifesaver. I only waited an hour when I got there. Their telephone triage was very good and they worked well with NHS direct and the doctors listened carefully. I can recommend the service. It seems to me a lot more sensible than every GP service having to be open.
- David, London
A shambles that has been vigorously defended by Mrs Hewitt and her hangers-on for months, while perfectly sane people who didn't happen to be new labour zealots or to be blinded by Mr Blair's fixed grin and cheerful chappy manner had been saying exactly that. And its not the only one by a long way.
- Peter Haldane, London
I have been disappointed by both the 'out of hours' care and NHS Direct. A few years ago I tried to contact a GP at the weekend for my late mother who had multiple medical problems. The call centre spent more time logging my details than information about my mother. When I heard nothing a few hours later I rang back to find they had lost the call details. Over 5 hours later I got to speak to a GP who had no knowledge of my mother's condition and suggested I rang her own GP on the Monday. Feeling totally unsupported I made my own decision about changing my mother's medication. On the Monday her GP confirmed that I had done the right thing.
Sadly I have to concur with Rick. My GP practice used to run an emergency surgery on Saturday morning. The one time I went (in considerable pain) it was crowded with people, 95% of whom had no need of emergency treatment. One woman had brought her 10 year old to the emergency surgery because she did not want him to miss school. All she wanted was for him to be checked over after getting over a cold! Perhaps there should be a penalty system for those who waste GP's time or go to 'A&E' for no good reason
- Michael, London
My partner is a GP and remembers well the nights on call dealing with huge quantities of very minor complaints, moans and groans and social problems through the night and at weekends. Only a tiny proportion of what she dealt with actually amounted to anything like a genuine medical emergency and warranted getting the doctor up at night. There is no other nation as far as I know that as an out of hours GP service which the Public can use as often as they like, for whatever reason they see fit and at no cost whatsoever to themselves.
It's the calssic scenario of "Well the service is free and limitless, it's my boirthright so let's use it as much as possible".
The UK Public have been corrupted by 60 years worth of Welfare State. Wake up feckless inadequate UK people because the money isn't there anymore and nanny isn't going to be there to wipe your noses for you 24/7 for much longer.
Finally, GP's are still woefully underpaid for the service they provide despite what the papers may say.
- Rick, Canterbury
I feel greatly reassured by the DoH's spokesman's comment that it's only rural and urban areas which have been badly hit.
- Rory, East Yorks, UK
