Member News
By Lord Naseby - 8th March 2010
Lord Naseby writes for ePolitix.com ahead of his question on out of hours GP services.
One of the key tenets of the NHS used to be the availability of committed and caring GPs, day and night. I had first-hand experience of it for 25 years, as my wife was a full-time GP in a practice first in Hackney, London and then in Biggleswade, Bedfordshire from 1973 until she retired in 1997.
It worked, but it required stamina of our GPs, particularly in later years as patients became more demanding and seemed less able to handle minor medical challenges in the night or quite often when the pubs closed! By the 1990s it was clear there had to be some changes, as GPs were often called out three or four times a night, and still had to be at the surgery around 8:30am for morning surgery, visits and evening surgery.
The solution was to leave it to the practice or practices to join together and have a doctor on call who would not necessarily work the next day. This worked pretty well, but there were still weekends on duty, and pay for GPs was lagging behind other professions so disgruntlement grew.
In 2004, a weak secretary of state for health decided that almost all GPs could opt out of out-of-hours care, and it would be the responsibility of the relatively new Primary Care Trusts to organise. This was a huge mistake, as the NHS lost the personal knowledge of GPs.
The current structure of care is at best patchy, but too often 'shambolic' - not my words, but those of the greatly respected and all-party public accounts committee. In recent years the government has been warned a number of times that the service is not working as it should. These warnings have come from the National Audit Office and twice from the select committee on health. Sadly, all have been ignored.
I tabled my oral question, 'To ask HMG what action they propose to take to improve confidence in the out-of-hours cover for patients in the NHS' after I had read the report of the coroner into the death of David Gray and Iris Edwards in Cambridgeshire. It makes quite horrific reading. The coroner doesn't hold back, and has no fewer than 11 proposals for change. The minister in the Commons has stated that lessons have been learned from the death of Mr Gray, and he 'hopes we will give patients the level of out-of-hours primary care that they expect and deserve'.
Hope doesn't suggest much urgency to me, hence my question.
Dods Parliamentary Communications Ltd