Editorial: Blame the DH, not GPs, for out-of-hours

Why did health secretary Jeremy Hunt recently blame GPs, and the 2004 GMS contract freeing them from out-of-hours responsibility, for the rise in emergency admissions?

Was it, as Urgent Health UK chairman Dr Mark Reynolds suggests in our analysis on pages 23 and 24, to act as a 'smokescreen' for the coalition government's failures while introducing NHS 111 services across England last month?

Out-of-hours questions, including who should be responsible and whether GPs should play a greater part in commissioning services, seem likely to be a focus for debate at next week's LMCs conference in central London.

LMCs in Northern Ireland have already called for GPs to opt back in to organising and commissioning out-of-hours services (GP, 15 April).

Last month Mr Hunt even urged an east London CCG contemplating a renewed bid by its local GPs to take back out-of-hours responsibilities to 'be brave' (GP, 29 April).

Speaking personally in this issue of GP, BMA deputy chairman Dr Kailash Chand doubts that ministers really want GPs back in control and pinpoints the problems as underfunding and marketisation (page 23).

Elsewhere, there is agreement that the answer is not simply to turn back the clock to pre-2004, when exhausted GPs were struggling to deliver services they were simply unable to provide.

The social enterprise is currently the most popular model of provision of out-of-hours services, with member organisations which are not-for-profit, staffed from local practices and often with GP board members.

With the chaos surrounding NHS 111, the out-of-hours emphasis for clinically led commissioners must be on quality now. The likelihood of greater GP involvement in these services therefore makes sense.

The lesson Mr Hunt now needs to learn is that blaming GPs for the failings of government has the potential to alienate the one profession capable of rescuing the DH and NHS England from the very deep hole they are currently digging for themselves.

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