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Slightly aggrieved at the suggestion that general practitioners' jobs are daytime only, many of the respondents to the head to head on whether GPs should resume 24 hour responsibility for their patients remind us that GPs do still provide out of hours care, albeit in different organisational set-ups.1 2 Most think that extending GPs' working hours back to those before the 2004 contract is neither feasible nor desirable—mainly because of increased workloads, doctors' and patients' safety, and a total lack of financial incentives. Few think that GPs should be expected to have to “opt in” again.
Respondents are indignant at the government and primary care trusts for not fully accepting that organising out of hours care is their responsibility under the new contract; for feeding the public perception (via the media) of GPs as overpaid, greedy, and lazy; for creating unrealistic expectations in patients as healthcare “consumers” entitled to have their demands met at all times; and for expecting GPs to do more without adequate remuneration and compensation.
GPs working for out of hours providers are as well qualified and experienced as any others, they argue, and NHS complaints have increased in total, not especially for out of hours care. Many might consider providing out of hours care with the right “package.” Others do so successfully in local cooperatives staffed by doctors and other specialists, and calls have gone down.
And the way forward? One recommendation is specialists in primary care out of hours services, a separate, defined specialty with recognised qualifications and bespoke or mandatory training.
Competing interests: None declared.