The Committee found that preparations for the new service were shambolic, both at the national and local level. The Department took part in the negotiation of the new General Medical Services contract only as an observer, and only the doctors did well out of the deal on out-of-hours costs. The Department also failed to explain whether the service should be for urgent care or all unscheduled health needs.
The percentage of providers meeting the requirements for call answering, definitive clinical assessment and consultation times is extremely low. For example only 2% could report that they complied with one standard. Some providers were simply unable to report at all. The cost of the new out-of-hours service has also been some £70 million a year higher than foreseen.
Mr Dunne said: "Here in Shropshire those who used NHS Direct know what a mess it has been. Luckily, Shropshire County PCT health bosses realised it was not performing properly and soon re-engaged Shrop Doc to provide a more local service.
The Department of Health thoroughly mishandled the introduction of the new system of out-of-hours care. The department chose to act as an observer and no more in the negotiations with GP representatives. 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.
The new service is getting better. But the needs of patients are not best served by the ending of Saturday morning surgeries. They are not best served where access to advice and treatment is often extremely difficult and slow. And they are not best served where no one knows whether the new out-of-hours service is meant for urgent cases only or for any requests for help at all.
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."
