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| Version 1 | Version 2 |
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| Out-of-hours GP reforms attacked | Out-of-hours GP reforms attacked |
| (about 2 hours later) | |
| The government "thoroughly mishandled" the introduction of the new system for out-of-hours health care in England, say MPs. | The government "thoroughly mishandled" the introduction of the new system for out-of-hours health care in England, say MPs. |
| A Public Accounts Committee report found that preparations were shambolic, and that only GPs had done well out of the new arrangements. | A Public Accounts Committee report found that preparations were shambolic, and that only GPs had done well out of the new arrangements. |
| It said the service was now starting to improve, but performance was still not good enough. | It said the service was now starting to improve, but performance was still not good enough. |
| The Department of Health said the changes had benefited most patients. | The Department of Health said the changes had benefited most patients. |
| Prior to April 2004, GPs were responsible for providing out-of-hours care between 6.30pm and 8am on week days, and over the weekend. | Prior to April 2004, GPs were responsible for providing out-of-hours care between 6.30pm and 8am on week days, and over the weekend. |
| This hands-off approach to the costs of out-of-hours care was good news for the doctors but no one else Edward LeighCommittee of Public Accounts | This hands-off approach to the costs of out-of-hours care was good news for the doctors but no one else Edward LeighCommittee of Public Accounts |
| Under the new system they were able to opt out of this responsibility in return for giving up an average of £6,000 per year. | Under the new system they were able to opt out of this responsibility in return for giving up an average of £6,000 per year. |
| Responsibility for out-of-hours care would then pass to the local primary care trust. | Responsibility for out-of-hours care would then pass to the local primary care trust. |
| One leading member of the British Medical Association negotiating team has admitted that they were shocked at just how good the deal being offered was for doctors. | One leading member of the British Medical Association negotiating team has admitted that they were shocked at just how good the deal being offered was for doctors. |
| Incentive to opt out | Incentive to opt out |
| The committee criticised the Department of Health for not taking a direct part in negotiations over the new system. | The committee criticised the Department of Health for not taking a direct part in negotiations over the new system. |
| Edward Leigh MP, committee chairman, said: "This hands-off approach to the costs of out-of-hours care was good news for the doctors but no-one else. | Edward Leigh MP, committee chairman, said: "This hands-off approach to the costs of out-of-hours care was good news for the doctors but no-one else. |
| "They were given a strong incentive to opt out (a lot less work for a small loss of income) and a disproportionate amount of taxpayers' money is now having to be spent to provide the replacement out-of-hours service." | "They were given a strong incentive to opt out (a lot less work for a small loss of income) and a disproportionate amount of taxpayers' money is now having to be spent to provide the replacement out-of-hours service." |
| We would reject the implication that GPs were the only ones to do well out of this deal Dr Hamish MeldrumBritish Medical Association | We would reject the implication that GPs were the only ones to do well out of this deal Dr Hamish MeldrumBritish Medical Association |
| MPs also criticised the Department of Health for failing to explain whether the service should be only for urgent care, or all health needs. | MPs also criticised the Department of Health for failing to explain whether the service should be only for urgent care, or all health needs. |
| And they warned that the new system was costing £70m a year more than had been predicted. | And they warned that the new system was costing £70m a year more than had been predicted. |
| They criticised the end of Saturday surgeries, and said access to advice and treatment in some areas was difficult and slow. | They criticised the end of Saturday surgeries, and said access to advice and treatment in some areas was difficult and slow. |
| Despite improvements, the percentage of providers meeting requirements for call answering, definitive clinical assessment and consultation times was still extremely low. | Despite improvements, the percentage of providers meeting requirements for call answering, definitive clinical assessment and consultation times was still extremely low. |
| GP response | GP response |
| Dr Hamish Meldrum, chairman of the British Medical Association's GPs Committee, agreed many out-of-hours services left a lot to be desired. | Dr Hamish Meldrum, chairman of the British Medical Association's GPs Committee, agreed many out-of-hours services left a lot to be desired. |
| But he said it was not true that GPs were the only ones to benefit from the new deal, and the Department of Health had been fully aware at all stages of the negotiations about the opt-out price. | But he said it was not true that GPs were the only ones to benefit from the new deal, and the Department of Health had been fully aware at all stages of the negotiations about the opt-out price. |
| Dr Meldrum said the money lost by GPs for opting out of out-of-hours care was by no means the only funding made available to set up the new service, which proved GPs had been providing care at "way below cost price". | Dr Meldrum said the money lost by GPs for opting out of out-of-hours care was by no means the only funding made available to set up the new service, which proved GPs had been providing care at "way below cost price". |
| "When, with the full agreement of the government, primary care organisations took over responsibility for providing the out-of-hours service and in some places failed to make a good job of it - they try to blame the GPs. It's not right and it's not acceptable." | "When, with the full agreement of the government, primary care organisations took over responsibility for providing the out-of-hours service and in some places failed to make a good job of it - they try to blame the GPs. It's not right and it's not acceptable." |
| A Department of Health spokesman said most patients were benefiting from the new system. | A Department of Health spokesman said most patients were benefiting from the new system. |
| "Patients right across the country should now be assured timely and responsive care, including the guarantee of a face-to-face consultation with a GP if needed. | "Patients right across the country should now be assured timely and responsive care, including the guarantee of a face-to-face consultation with a GP if needed. |
| "We are aware that some areas face more challenges than others, including in very rural and very urban areas, and we are determined to ensure that out-of-hours services in every area match the standards of the best." | "We are aware that some areas face more challenges than others, including in very rural and very urban areas, and we are determined to ensure that out-of-hours services in every area match the standards of the best." |
| The Department has launched a "clinical audit toolkit" for out-of-hours care designed to help doctors, nurses and call handlers assess their ability to identify emergencies, the quality of their advice and the speed of their response. | The Department has launched a "clinical audit toolkit" for out-of-hours care designed to help doctors, nurses and call handlers assess their ability to identify emergencies, the quality of their advice and the speed of their response. |
| The NHS Confederation said the report was based on the first year of implementation of the new service, and it would be unfair to assume that was an accurate reflection of the situation now. | The NHS Confederation said the report was based on the first year of implementation of the new service, and it would be unfair to assume that was an accurate reflection of the situation now. |
| Commenting on the Public Accounts Committee report Liberal Democrat health spokesman , Norman Lamb MP said: ¿Yet again, the Government has grossly mishandled an NHS contract, putting further pressure on cash-strapped trusts and leaving patients confused about where care is being provided. ¿The effect of this mess is that A&E services will be swamped by patients who don¿t know where else to turn." |