No, Jeremy Hunt’s comments on the 2004 contract were on the button, even though he’s now had to retreat in the face of fury from the doctors’ union, the BMA.

The 2004 contract allowed GPs to opt out of “out-of hours” care in return for sacrificing £6000 a year in their pay packets, although this drop was more than compensated by huge bonuses for hitting patient care targets.

Unsurprisingly, 90% of doctors chose to stop working nights and weekends, and the buck stopped with Health Managers working for Primary Care Trusts. The result was a mess, with all sorts of groups from GP co-operatives to private companies getting in on the act and with no-one quite sure about what an “out of hours” service really meant. There was little or no continuity of care, and no-one knew whether it was there for urgent treatment or was simply a holding bay for GPs.

No wonder patients have flooded into hospital A&E departments with all sorts of ailments which previously they’d have taken to their GPs. But A&E Departments are designed for exactly that – Accidents and Emergencies. They are absolutely not the solution to the after-hours-care which individual GPs have by and large abandoned.

I don’t have any easy answers as to how this service can best be provided. But I do have a problem with Labour complaining blaming the current government for a situation they themselves created.

No, Jeremy Hunt’s comments on the 2004 contract were on the button, even though he’s now had to retreat in the face of fury from the doctors’ union, the BMA.

The 2004 contract allowed GPs to opt out of “out-of hours” care in return for sacrificing £6000 a year in their pay packets, although this drop was more than compensated by huge bonuses for hitting patient care targets.

Unsurprisingly, 90% of doctors chose to stop working nights and weekends, and the buck stopped with Health Managers working for Primary Care Trusts. The result was a mess, with all sorts of groups from GP co-operatives to private companies getting in on the act and with no-one quite sure about what an “out of hours” service really meant. There was little or no continuity of care, and no-one knew whether it was there for urgent treatment or was simply a holding bay for GPs.

No wonder patients have flooded into hospital A&E departments with all sorts of ailments which previously they’d have taken to their GPs. But A&E Departments are designed for exactly that – Accidents and Emergencies. They are absolutely not the solution to the after-hours-care which individual GPs have by and large abandoned.

I don’t have any easy answers as to how this service can best be provided. But I do have a problem with Labour blaming the current government for a situation they themselves created.

Sorry that came out twice.

The last govt didn’t believe that out of hours was an important part of the service. They wanted doctors quizzing people about their smoking/drinking/eating habits, filling in boxes so that scare stories about mythical health epidemics could be manufactured from this “evidence”, even as average life expectancy increases by the day. Classic case of a public service serving the Government rather than the public. Building the client state and self-justification for more funding for “health campaigns”. It’s why now we have an NHS that wants to give lifestyle advice to 25 year old gym instructors, whilst old ladies die of dehydration on the wards and people queue in corridors for A&E. Now of course, it’s impossible to get the service back as no GP is going to volunteer to do it without a hefty pay rise. Polyclinic anyone ?

The OP says ‘Jeremy Hunt did not visit a single A&E department until April this year – six months after he was appointed’ – but why should he?

The coalitions health reforms have nothing to do with evidence, or reality on the ground – it is a dose of neo-conservatism pure and simple.

Hunt, the man instrumental in handing a large part of our media to the dirty digger (until the tapping of murder victims phones came to light) has now been tasked with ensuring that the corporations gain as much control of the NHS and as soon as they can.

A&E’s could see 110% of patients in under 4hrs and it still wouldn’t affect this drive toward market solutions – if Burnham was honest enough, he would admit NuLab had been ploughing exactly the same field.