Out-of-hours service 'falling apart' warn Northern Ireland GPs

The out-of-hours service in Northern Ireland is 'falling apart' because of underfunding, GP leaders have warned.

Dr Alan Stout: out-of-hours funding shortfall (photo: BMA)
Dr Alan Stout: out-of-hours funding shortfall (photo: BMA)

Speaking at Sunday’s annual Northern Ireland LMCs conference, GPC Northern Ireland chairman Dr Tom Black said the service would ‘fall over’ this year because of workload and workforce pressures.

The conference called on the government to act urgently to address the severe underfunding.

Southern LMC chairwoman Dr Frances O’Hagan said people needed to realise the service was ‘disgracefully underfunded’.

GPC Northern Ireland believes funding has fallen from £23m in 2004 to £21m today, and is negotiating with the Department of Health, Social Services and Public Safety for GPs to take full control of the service from trusts under non-profit mutual organisations, but with no return to individual or practice responsibility.

In February the minister and GPC leaders signed a framework agreement for the out-of-hours service. The government is understood to have proposed a 10% funding increase to the services, but GPC has called for a rise closer to 70%.

Dr O’Hagan said the service would need a 100% funding increase for equivalent funding levels to the English and Scottish services.

‘People need to realise just how bad things are,' she said. ‘It’s going to fall over.’

Following the recent closure of an out-of-hours centre in Armagh, she said in her area there was an out-of-hours services from 7pm to 11pm, no A&E, and no minor injuries service after 6pm. ‘If someone gets really sick, they could be travelling up to thirty miles.’

‘It’s falling apart because the funding is just so bad, she said.

The conference called on Northern Ireland's health minister to recognise the service was severely underfunded, and backed the current GPC position to negotiate for a local, accessible service run by GPs.

Representatives threw out a motion calling on GP leaders to walk away from discussions with the department.

Secretary of Western LMC Dr Martin McCloskey said GPs should ‘walk away’ and ‘stop banging our heads against a brick wall’. ‘Perhaps it needs to be allowed to fall apart,' he said, before the government recognises the problem and GPs can negotiate proper funding. ‘A good crisis achieves more than good intentions,' he added.

Assistant secretary of Eastern LMC and GPC Northern Ireland deputy chairman Dr Alan Stout said it would be ‘counterproductive’ to walk away from discussions as it was too important and there would be implications for day-time care.

Dr Stout warned that without GP involvement ‘other agendas’ such as an NHS 111-type service could be imposed.

Dr O’Hagan warned of the implications for patient care if GPs walked away.

GP leaders would continue to show the department the facts and make the case for increased funding, said Dr Black, but he warned that workforce would act against the service because of the escalating workload.

‘We need to retain our control of and our independence for general practice. Out-of-hours is out of our hands at the moment, I suspect it will fall over at some stage this year due to workforce and workload problems,' he said.

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