GP out of hours reform slammed by MPs

Health bosses in Norfolk have admitted for the first time that they were forced to raid financial reserves after the government failed properly to fund the GP out-of-hours services.

Norfolk Primary Care Trust, which is £47m in the red, says the Department of Health failed to come up with adequate funding when the plan was implemented in 2004 following the introduction of new GP contracts.

The admission comes as an influential group of MPs labelled government prep-arations for a new out-of-hours GP service as “shambolic” with the handover of care from doctors to PCTs riddled with flaws.

The cross-party Commons Public Accounts Committee (PAC), which today publishes its report into out-of-hours services nationally, said the cost of the new out-of-hours service was about £70m a year higher than had been predicted.

Under the new contract, GPs' practices lost an average of £6,000 a year by handing over weekend and evening cover to what was then six PCTs across Norfolk, which agreed jointly to commission the new service.

A spokesperson for the new Norfolk PCT said: “All Norfolk practices decided to opt out and it was agreed nationally that opt out practices would have £6,000 per annum taken from their budgets which would go towards covering the cost of an out of hours service.

“All the money given back to the PCT to pay for the new service was insufficient to cover the cost and it should have been a much greater, more realistic contribution.

“As a result the Norfolk PCT consortia could not fund the original service model they had drawn up and had to dig into their other resources to make up the difference.”

Anglian Medical Care (AMC) - operated by the ambulance trust - currently provides the service, but that contract is now up for renewal with the PCT looking for a cheaper version of the current weekend and overnight cover for GPs. A decision should be known by early-summer.

The PAC found that nationally the service was now starting to improve but the performance of trusts against key targets was “still not good enough.”

Its report said: “We found preparations for the new service were shambolic, both at the national and local level.”

PAC chairman Edward Leigh said: “The Department of Health thoroughly mishandled the introduction of the new system of out-of-hours care. The hands-off approach to the cost of out of hours was good news for doctors but no one else.

“To cap it all, the cost of the new out-of-hours service is around £70 million a year more than was expected. That's the last thing the primary care trusts need at this time of increasing financial pressure.”

PAC member and South Norfolk MP Richard Bacon called on the government to decide what sort of out-of-hours medical care it wanted the NHS to provide.

“The Department of Health's 'hands off' approach left local trusts clueless over the kind of service they were supposed to be providing. Officials must give Trusts the clarity they need on the sort of out-of-hours service they should be providing,” he said.

Liberal Democrat Shadow Health Secretary Norman Lamb and North Norfolk 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.”

In Norfolk GPs are warning that patient care could suffer if health chiefs opt for a cut-price service.

Mundesley GP Dr Pete Henley said: “No company can offer a cheaper service than AMC without jeopardising lives.

“I and most of the other out-of-hours doctors will not work for a company that will put people's lives in dangers.”

In response to the PAC report Health Minister Andy Burnham said: “Most patients are benefiting from improvements in out-of-hours services.

“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.”