Jeremy Hunt 'confused and hypocritical', GPs warn

Health secretary Jeremy Hunt's plans to overhaul GPs' out-of-hours role and enforce a tougher inspection regime are 'confused and hypocritical', GP leaders have warned.

Mr Hunt said that the GP contract was likely to change to hand out-of-hours responsibility back to GPs. He said practices should be responsible for ‘signing off’ that they are happy with the out-of-hours care provided for the patients on their list.

The health secretary also called on GPs to improve access to practices, while pointing out that pressured GPs were victims of a 'box- ticking culture', preventing them from focusing on patient care.

But GP leaders said Mr Hunt's remarks were confused and hypocritical. They warned that if the government continued to suggest GPs would be forced to take back part or full responsibility for patients out of hours, many would quit.

GPC chairman Dr Laurence Buckman said the box-ticking NHS culture had been made worse by policies imposed by Mr Hunt's own government.

Derbyshire LMC secretary Dr John Grenville said Mr Hunt's comments were hypocrisy. 'I'd believe he meant that if his actions reflected his words,' he said.

Londonwide LMCs medical director Dr Tony Grewal condemned Mr Hunt's 'contradictory' proposals.

'You can't increase demand on choice, quality, access and productivity when general practice has already reached or gone beyond its limit, to the point where we are possibly being unsafe. GPs have nothing more to give, other than their resignations,' he said.

If the government wanted more from GPs, it would have to invest, he said. 'You can't build Rolls Royces on Skoda prices. Unless you have more money and a bigger factory, you can't build lots of expensive cars.'


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Workload pressure

Deputy GPC chairman Dr Richard Vautrey said Mr Hunt's 'revelation' that GPs were under huge pressures of workload and bureaucracy was 'quite remarkable'.

'Mr Hunt was at the helm when this government imposed the last contract changes,' he said.

Mr Hunt also announced plans for a new chief inspector of general practice at the CQC.

The announcement coincided with the start of the UK LMCs conference in London. LMC delegates are due to debate an emergency motion to send a 'categorical' message they will not take back out-of-hours provision.

Dr Peter Graves, chief executive of Bedfordshire and Hertfordshire LMC, which tabled the motion, said many GPs would quit if forced to take on an out-of-hours role.

Dr Grenville accused ministers of 'playing to the gallery' for a press that wanted a contract to force GPs back into out-of-hours care. He warned Mr Hunt 'would be a fool to try'.

Mr Hunt told MPs on Tuesday the 'disastrous' 2004 GMS contract, signed by the previous government, was a significant cause of rising A&E demand. But experts from the NHS Confederation and the King's Fund have dismissed the link.

Dr Buckman suggested Mr Hunt was simply 'firing shots for the next election' and playing politics by using GPs to attack Labour.

A DH spokeswoman said Mr Hunt believed out-of-hours services did not provide a 'credible alternative' to A&E. He wants to 'end the fear faced by patients who need out-of-hours care', returning to a system where GPs know their patients' names.

There was less hostility from GP leaders to the idea for more involvement by GPs in organising out-of-hours. Dr Buckman said he was not opposed to a return to GP co-ops, pointing out that in areas where they remained in operation, patients 'often do know the GP who treats them'.

RCGP chairwoman Professor Clare Gerada told BBC Newsnight that GPs should take responsibility for commissioning all out-of-hours services. To do so, however, there would need to be more GPs.

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