Editorial: Do GPs want a return of 24-hour responsibility?

Have you ever tasted 'a cup of cold vomit'?

That was the memorable comparison made at last year's Welsh LMCs conference to describe the prospect of the return of 24-hour responsibility.

It may not feel as though the ink has long dried on the 2004 new GMS contract but its days now look certain to be numbered.

At last week's NHS Alliance conference in Manchester both the Conservatives and the King's Fund suggested as much.

Shadow Conservative health secretary Andrew Lansley confirmed his belief that GPs in England should commission 24-hour care for their patients but added that a new non-UK contract would be needed to enable this.The King's Fund wants balanced scorecards to play a larger role in GPs' contracts.

Last week GP reported that RCGP chairman Professor Steve Field backed returning 24-hour responsibility to GPs.

This week BMA chairman Dr Hamish Meldrum argued instead that commissioning should be a collaborative process between NHS organisations, including GPs.

Returning 24-hour responsibility to GPs has been a notoriously divisive post-new GMS issue for the profession.

Supporters argue that it would ensure continuity of care and give GPs greater control over who provides services in their areas.

Opponents say that opting out of it was one of the major attractions of the 2004 contract and that they do not want to be working out-of-hours again.

Contributors to our website Healthcare Republic are predominantly against the change (see Letters, page 22) which would appear to put them at odds with Tory party policy. But what does the wider profession think? Do write and tell us how you feel about the prospect of the return of 24-hour responsibility.

Is it like a cup of cold vomit or something rather more appealing? After all, if the Tories sweep to power in spring 2010 it is likely to be at the top of their new GP contract negotiating agenda.

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