Out-of-hours health shambles is blamed for up to 35 patient deaths

Complaints about the service have risen by almost a fifth, with common criticisms including a failure to diagnose a condition properly and delays in visiting patients.

The statistics come from an analysis of grievances passed on to the Medical Defence Union, Britain's biggest insurer of GPs and dentists.

They reveal that complaints about inadequate out-of-hours provision rose from 155 in 2005 to 182 the following year.

Thirty-five came from friends and family of patients who had died.

New contracts introduced by Labour three years ago saw 90 per cent of doctors opt out of providing care in the evenings, at weekends and on Bank Holidays.

But, while GPs' hours have been cut, their salaries have soared by almost 60 per cent to an average of £106,000.

Patients, meanwhile, have been left to negotiate an out- of-hours maze, with many passed from pillar to post as they deal with NHS Direct staff, co-operatives of GPs and agency doctors roped in to provide some sort of cover.

Examples of nightmare callouts included a 34-year-old man with a chest infection and breathing difficulties who was seen by an out-of-hours GP.

The doctor prescribed an antibiotic and said he would ask a GP from the man's own practice to check on him the following day.

But he forgot to do this and the patient was found dead the following night from pneumonia.

Last month, an inquiry blamed 'serious flaws' in out- of-hours services for the death of a mother who saw eight doctors in four days.

Penny Campbell, 41, died of multiple organ failure caused by blood poisoning after on- call GPs repeatedly misdiagnosed her condition. She spoke to six doctors on the telephone and had two faceinvariablyto-face consultations after her local surgery in North London closed for Easter in March 2005.

But they all failed to recognise the seriousness of her condition, with one doctor claiming she would not be able to talk on the phone if she was as ill as she claimed.

Dr Stephen Green, of the Medical Defence Union, said: "While it is too early to discern trends in the complaints and claims notified to the MDU under the new system, there are some common themes to which we draw our members' attention.

Difficulties with communication are involved, such as out-of-hours doctors not having access to patients' records.

"Accurate records are always important for communication in ongoing care and never more so when managing patients out of hours.

"It is also vital there are reliable links between GPs at a patient's practice and out-of-hours providers."

The union added that the number of deaths may have been fewer than 35, as there may have been more than one complaint about the handling of some patients.

A Department of Health spokesman said: "Access to medical records is an issue that pre-dates the current outofhours system.

"Seven out of ten GPs did not provide their own out-of-hours service under the old arrangements and co- operatives would not have access to individual patient notes in GP surgeries.

"That is why the Government is placing such great importance on getting electronic care records online as soon as possible.

"We have also issued directions to all primary care trusts requiring them to review their arrangements for the transfer of information between clinicians to safeguard patient safety and to change contract requirements where necessary.

"A recent National Audit Office report confirmed that eight out of ten patients are satisfied with the service, while six out of ten rate the service as excellent or good."