Editorial: GPs should provide 24-hour care

The Health Secretary has blamed the declining quality of out-of-hours care for soaring attendance rates at hospitals’ emergency departments. He's right

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Traditionally, secretaries of state for health have been wary of provoking the medical profession. Not only is the British Medical Association a powerful union, doctors and nurses also command considerable support and respect in their communities.

Jeremy Hunt, however, appears to be throwing caution to the winds. At last weekend’s nursing conference in Liverpool, he accused nurses of putting their own interests ahead of their patients’. Yesterday it was GPs’ turn, as the Health Secretary blamed the declining quality of out-of-hours care for soaring attendance rates at hospitals’ emergency departments.

For all the risks associated with so blunt an attack, Mr Hunt’s theme will strike a chord with a public fed up with a difficult-to-access GP service and ever-longer waits in A&E. Even more so given that the problems are, in large part, due to changes made to the GP contract in 2004, under which most family doctors divested themselves of responsibility for providing round-the-clock services in return for sacrificing just £6,000 a year. Not only was such a sum insufficient to fund an adequate alternative, it was also levied at a time when many GPs saw their incomes leap above six figures.

The result has, too often, been cut-price care and a declining service, the most terrible example of which was the 2008 death of David Gray, who was given 10 times the correct dose of morphine by a German locum flown in to provide weekend cover.

Mr Hunt yesterday acknowledged other causes for the pressure on A&E – Britain’s ageing population, for example. But he also signalled his intention to address the “system failures” caused by the GP contract, starting with out-of-hours care. Quite right. Persuading family doctors to take back 24-hour responsibility for their patients will not be easy, but the Health Secretary should take the initiative nonetheless. It is one that could extend access, improve care, ease pressure on hospitals – and even be a vote-winner at the next election.

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