GPs seek fines for trivial call-outs

TWO-THIRDS of family doctors would like patients to face fines or fees if they call them out at night for trivial reasons, a survey of GPs showed yesterday.

The finding has horrified both the Department of Health and the British Medical Association. But Dr Ian Bogle, chairman of the BMA's general medical services committee, said: 'It shows clearly the strength of feeling about the present arrangements for providing out-of-hours care.'

The survey by Doctor magazine of almost 3,000 GPs - about 10 per cent of the total - showed doctors protesting they had been telephoned out-of-hours by patients who had run out of tampons, lost the key to the medicine cabinet, or discovered they had pubic lice.

A GP from Lincolnshire claimed he was called at 4am by a man who had suffered a bad knee for six months, but wondered if the doctor 'might come and look at it'. A patient in Bath wanted an out-of-hours visit 'to see if she could attend a cocktail party'. A Northamptonshire patient, according to the survey, called at 2am to ask her GP the time of the first bus to her out-patient appointment that day.

Seven out of ten GPs in the survey said they feared they would be unable to attend a genuine emergency because they were busy dealing with trivial calls. Overall, they judged barely a quarter of their calls to be genuine emergencies, with half able to wait until the next morning, and a quarter positively unnecessary.

Two-thirds of those replying to the survey said they would like a fine or a fee if patients called up unreasonably; 18 per cent wanted the right to remove such patients from their list. The Department of Health, however, said: 'We have no plans to introduce such fines. Any such scheme is likely to deter people from seeking the help they need in an emergency.'

The BMA is currently involved in talks with Dr Brian Mawhinney, the Minister of Health, about switching much of out-of-hours care to primary care centres, with patients travelling to properly equipped surgeries and GPs visiting patients less often. Lack of transport, however, was one of the most common reasons for patients asking for an out-of-hours visit.

The Department of Health is also working with the BMA to produce an educational package for GPs' surgeries about when patients should use the out-of-hours service.

David Blunkett, Labour's health spokesman, said: 'I don't underestimate the very real annoyance which GPs feel about non-urgent night calls,' but he added that 'what appears trivial to an experienced GP may not be seen as such by a worried patient or the mother of a sick child'.