GPs set to snub out-of-hours care services

Most GPs also think they they will not be given sufficient funds to commission a safe service for nights and weekends, according to the Pulse magazine survey.

Health Secretary Andrew Lansley is handing GPs power to commission NHS services, which will see them handle most of the NHS budget.

They no longer provide out-of-hours care as part of their contract, after negotiations with the Government in 2004 led to them dropping it.

The out-of-hours service is currently run by primary care trusts (PCTs), who commission services from in-house teams and private firms.

Under the new arrangements, GPs will take on responsibility for commissioning out-of-hours coverage but it is believed many will choose not to do the work themselves.

The survey of 415 GPs found just one in eight (13 per cent) planned to actually take on providing out-of-ours care, 64 per cent said they would not and 23 per cent did not yet know.

Mr Lansley has said previously he believes that if GPs are responsible for budgets and commissioning out-of-hours care, most will decide to go back to offering cover themselves or in local groups.

Yesterday's poll found only one in seven doctors thought they will receive sufficient funding to commission a safe service.

Many GPs said far more money would be needed to offer a safe and effective service than they were paid to provide it before 2004 or what PCTs have been given since.

GPs gave up 6,000 each when they opted out of responsibility for providing out-of-hours care under the 2004 contract.

But the poll found they estimated 15,000 each would be needed to fund a safe service going forward.

Just 14 per cent said they thought there would be enough funding, with 66 per cent saying it was unlikely to be sufficient. Some 20 per cent said they did not know. Overall, 54 per cent of GPs did support taking a "central role" in commissioning out-of-hours compared with 38 per cent who opposed it.

Pulse editor Richard Hoey said: "The Government badly undervalued the out-of-hours service GPs were providing pre-2004, and as a result never provided PCTs with the funds to match the spiralling costs.

"Our survey reveals widespread concern among GPs that exactly the same will now happen to them, and they will be left with responsibility for out-of-hours care without the funds to deliver it safely.

"GPs are willing to take on out-of-hours commissioning, but they need the resources to make it work, and they're not going to be railroaded into a return to the bad old days of round-the-clock workload."

Dr David Bevan, a GP in Wisbech, Cambridgeshire, told Pulse: "It was PCTs' inexperience and cost cutting that made their responsibility for out-of-hours a disaster.

"GP consortia will be handed inadequate budgets and enhanced expectations to sweep up after PCT incompetence."

A spokeswoman for the British Medical Association (BMA) said: "Under the arrangements proposed in the White Paper, funding for out of hours will not be given out separately.

"Instead, GP consortiums will be allocated an overall budget, from which they will decide how much funding to allocate to out of hours, as well as all the other services they will be commissioning.

"Individual GPs will still be able to choose whether they do out-of-hours work themselves."

A spokesman for the Department of Health said: "Out-of- hours care needs urgent reform and GPs are best placed to ensure patients get the care they need, when they need it.

"The Government is committed to putting GPs in charge of commissioning local health services, including out of hours services which will be commissioned as an integral part of a high quality 24/7 urgent care system.

"Our proposals are not intended to force GPs to take on responsibility for providing out- of-hours services themselves but, as the Pulse survey results themselves show, more GPs are considering providing the service themselves than are currently opted in."