Sir, As a now long retired GP who entered practice in the NHS two months after it started I totally agree with Libby Purves (“If you must get ill, make sure it’s before 6pm”, Opinion, Jan 18). For most of my 38 years as a GP, I, or one of my partners, was responsible for the continuous care of our patients 24 hours a day, year in and year out.
In those days general practice was regarded as a vocation, not a 9 to 5 office job; we expected to do it, and took pride in the service we gave to our patients. I am a lifelong member of the BMA and have in the past attended many meetings at which the view was expressed that we should not have to be responsible for the care of our patients 24/7, as the modern expression goes. I was never in sympathy with this view, as it seemed obvious what the result would be, as has proven to be the case.
I am sure my opinion will not be popular with my former colleagues, and I have little doubt that any attempt by the Government to turn back the clock will be vigorously opposed by the BMA.
Dr B. C. Conochie
Linton, Cambs
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Sir, I understand why, as a patient, Libby Purves wants to see a return to “the good old days” when, if you got ill, it was your family doctor who visited you in the early hours of the morning. I also agree that the current system needs changing. However, Ms Purves is viewing the past through rose-tinted glasses. For doctors, being on call 24 hours a day, seven days a week, took its toll; individual GPs were left permanently exhausted and the profession was facing a recruitment crisis. Those nearing retirement were getting out early and those looking to enter general practice were put off when they saw how burnt out they, too, would become. That is why most family doctors handed over responsibility for out-of-hours care when it was offered to them; with the number of out-of-hours calls rising all the time they couldn’t physically do it any more.
The old system meant many doctors were tired and therefore potentially dangerous to patients and it is for that reason that the BMA, and the GPs it represents, would resist a return to doctors taking back personal responsibility for delivering care out-of-hours. However, some sort of middle ground needs to be reached as patients deserve better than they are getting now.
The BMA wants to see primary care trusts commissioning out-of-hours care with the involvement of local GPs, better investment and a focus on more rigorous monitoring of out-of-hours services. But we can’t go back to a potentially dangerous old system which would, once again, have an impact on the quality of care patients receive in-hours and was therefore good for no one.
Dr Laurence Buckman
Chairman, GPs Committee British Medical Association