In 2004 the British government changed the way that out of hours GP services were provided to the public.
The changes to GPs' contracts were controversial because they allowed GPs to opt out of treating patients outside normal surgery hours. Under the new GP contract, responsibility for treating out of hours patients was transferred to Primary Care Trusts.
Immediate results of the 2004 GP contract changes
Opting out of providing out of hours treatment to patients resulted in a £6,000 annual loss in salaries for GPs but many GPs opted out all the same.
However, the old system of out of hours care had not been without fault. Often Doctors worked throughout the night and during the following day in their surgeries which meant they were too tired to provide a proper day time service.
Ongoing controversy for the 2004 GP contract
Jeremy Hunt, the Secretary for State for Health has argued that the growing pressure on hospital emergency departments is one of the biggest challenges facing the NHS. He recently blamed the changes to the GP contract for the rising numbers of A&E patients and suggested that patients who attend A&E as an alternative to out of hour’s surgery do not get the medicines, checks or support they need.
In addition to that overarching criticism, the Health Secretary believes there has been a “fundamental failure” by the NHS to properly care for the rising number of elderly patients dealing with long term health conditions. He is therefore determined to affect a huge overhaul of the system to ensure there is more preventative treatment and community based care.
Politicians versus practitioners
The Health Secretary’s criticism of GPs has been met with firm resistance from the medical profession. Recently at the BMA's annual conference, a motion expressing no confidence in the Health Secretary was endorsed by an overwhelming majority.
Dr Jacky Davis, a consultant and a member of the BMA's ruling council argued that the Health Secretary is blaming frontline NHS staff for Government cuts and reforms. Similarly, Dr Clare Gerada, chair of the Royal College of General Practitioners, released a statement saying that GPs were being used as a scapegoat. She notes that there is no evidence to support the minister’s claim that GPs and a reduction of out of hour’s services are responsible for the rising number of A&E patients.
Mike Farrar of the NHS Confederation also cited a lack of evidence supporting the correlation between the changes and the waiting time at A&E Departments, and noted for the past decade waiting times at A&E have been improving. Farrar argues there are simply increasing pressures on the system as a whole.
Dr Chaand Nagpaul of the General Practitioners Committee has criticised the Health Secretary's comments arguing that the Health Secretary’s position is insulting to the medical profession. He argues that the minister’s comments fail to reflect the effort and hard work of GPs and makes allegations about GP performance which are unsubstantiated. In reality the 2004 contract has resulted in a reduction in resources for GPs. The medical profession is of the opinion that the issue with the 2004 contract is the manner in which it has been used by the Government. In recent years the contract has been used to increase workload without adding the resources necessary so to do.
Comment
One thing that is clear is the increasing pressure medical practitioners are under when carrying out their professional duties. This can sometimes lead to mistakes or criticisms of individuals being made that result in disciplinary procedures being taken against them. It is essential that healthcare professionals facing disciplinary proceedings seek advice from a specialist solicitor as soon as a concern is raised. For more information contact our professional discipline team on 01616 966 229 or complete our online enquiry form and a member of the team will make contact with you directly.