BMA chairman Dr Mark Porter said there was a lesson to be drawn from the fact that the government was ‘extraordinarily happy’ with a GP contract deal on out-of-hours that was not as bad for GPs as many had feared.
He said: ‘One of the things they are happy about, we haven't actually talked about in that contract - about reforming all the out-of-hours stuff the government has been talking about to the press for the last three or four months.’
In briefings earlier this year, DH officials suggested GPs could be forced to take back control of out-of-hours services. Health secretary Jeremy Hunt said in speeches that doctors would be responsible for signing off to say they are satisfied with the service commissioned for their patients.
The final contract agreement requires GPs to monitor out-of-hours services in their area and report any concerns.
Dr Porter said the contract agreement ‘tells me something about the government’s political priorities on the one hand in terms of blaming doctors for the current mess, and on the other in terms of actually moving forwards.’
Speaking at a Westminster Health Forum event on seven-day services and urgent care, Dr Porter said in improving GP out-of-hours care, ‘you wouldn’t start from here’.
There had been a systematic disinvestment in services, he said, which was why many GP were happy to give up personal responsibility after 2004. The introduction of NHS 111 led by non-clinical call handlers felt like a ‘further attempt to extract investment from the service’.
‘If we want good general practice out of hours, commissioners need to be commissioning good general practice out of hours.’
Good examples of services often involved GP co-ops, he said, which should be encouraged and resourced by commissioners ‘to get general practice working; rather than saying, how can we save money’.
