Tories are backing out-of-hours loser

We are told that a week is a long time in politics, but this week brings proof that, when it comes to health policy, a month can bring about changes that seem eras apart.

At the end of August, we revealed the results of our latest survey on GPs' voting preferences which showed 48 per cent of respondents favoured the Conservative Party compared with only 23 per cent for Labour (GP, 31 August).

The reasons for the shift away from Labour were GP bashing, including the on-going out-of-hours and extended opening debate, and the failures of NHS reform. The Tories delightedly trumpeted their success in our poll, setting themselves out as the true friends of the health service and GPs. Yet, at the end of September the Conservatives have unveiled a health policy document set to alienate all GPs by harking back to the pre-new-GMS era.

If elected they promise to renegotiate the GP contract to return responsibility for out-of-hours to GPs. You would, of course, be allowed to commission out-of-hours providers or co-ops to perform the service on your behalf. So, a complete and utter return to the old system - the one that GPs were so desperate to negotiate away from.

The document acknowledges that it costs primary care organisations (PCOs) three times as much as the income practices gave up in the opt-out to provide these services. However, it makes no mention of extra funds for GPs in the future.

The reason that out-of-hours services have problems at present is that the transfer of responsibility to the PCOs has revealed that it has been chronically underfunded for years and that GPs had been picking up the slack to the detriment of their health and home lives.

Returning responsibility to GPs will not recreate some Finlayesque golden age of each GP doing their own on-call. Instead it will just add strain to an overstretched profession.

Proper investment in a modern out-of-hours service with national standards is the only way forward, not juggling it between commissioners like a red-hot and somewhat rotten potato.

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