New government’s out-of-hours care plans `flawed’
More staff and extra cash will be needed, says Suffolk GP
SUFFOLK: The new coalition government could be about to clash with England’s GPs in a row over out-of-hours care.
New Health Secretary Andrew Lansley is insisting that responsibility for night-time and bank holiday visits will be taken away from primary care trusts and handed backed to co-operatives of doctors who would commission services or provide cover themselves working in rotas.
For six years, primary care trusts have been responsible for covering unsocial hours care after GPs contracts were renegotiated to ensure they managed chronic illnesses during the daytime.
To provide cover, care providers contracted by the PCTs employed overseas speaking little English, leading to thews the tragic death of a Cambridgeshire pensioner who was given ten times the correct dose of diamorphine by a German doctor.
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Ipswich MP Ben Gummer said Mr Lansley was right because PCTs were no being flexible in letting the contracts. “They are tBe who could not speak English but contracted to provide out of hours care.
Dr Mark Hainsworth, whose Bildeston practice does provide after hours serve, said the Secretary of State’s policy “ain’t going to happen” without more doctors and a renegotiation of contracts.
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“He seems to have overlooked that six years ago, doctors’ contracts were renegotiated to ensure they managed chronic illnesses during the daytime.
“Doctors will not go back to working long hours during the say and evening, which means extra doctors are going to have to be trained and recruited. And that takes time.
“He overlooks the fact that as doctors have not provided night-time care for six years, they will need training to bring them up to speed on emergency care.
“And doctors are reluctant to enter dimly lit premises late at night without a chaperon.
“Other factors overlooked are the EU’s working time directive on the number of hours which a doctor can be legally required to work, and that practices have a large number of part times and women doctors who will not or cannot work at night.”
Dr Hainsworth said: “For all these reasons, it ain’t going to happen unless resources are put into the service - and we’re told there’s no new money because of the economic crisis.”
Mr Lansley said foreign doctors who had been recruited by primary care trusts or their agents would in future have to ensure that GPs “have the relevant language skills to ensure that they are safe.”
He believes that if GPs are responsible for their own budgets, and have to commission out-of-hours care themselves, most will decide to go back to offering weekend and evening cover themselves or in local groups.
Meanwhile, the county’s out-of-hours GP service, which has been provided by Harmoni HS Ltd since April, has advertised for clinicians who can work after hours between Monday and Friday, and weekends.
Dr Roy Steiner, of Ipswich, the GP Clinical Lead with Harmoni, said: “We are conscious of the need to always have a plentiful supply of high quality clinical staff to call upon and, to this end, we periodically place recruitment advertisements in the local and medical trade Press.
“We are very aware of the long-standing national shortage of clinical staff, including GPs, available to work out-of-hours and in light of this, we continue to actively recruit to ensure Suffolk is covered not just by sufficient numbers of staff but the highest quality staff.”
Wendy Tankard, Director of Clinical Quality at NHS North East Essex, said: “We are confident that a quality out-of-hours service is currently being provided for local patients via a contract with Harmoni The contract is subject to robust monitoring procedures to ensure it continues to meet national quality requirements and that the service is running efficiently.
“Should national policy to out-of-hours provision change in the future then we will, naturally, respond to those changes.”