Thought the list might like to have a look at this article from today's Times.

February 15, 2005 

GPs sound alarm over cash shortage for care at night
BY SAM LISTER, HEALTH CORRESPONDENT


PATIENT care provided by GP services during evenings and weekends is being threatened by a shortage of cash, it was claimed yesterday. 
The National Association of GP Co-operatives (NAGPC) said that changes to the running of out-of-hours patient care, introduced with new contracts for family doctors last April, had led to a funding shortfall which may force some services to close. 


Health leaders and politicians yesterday called for the National Audit Office, the independent financial watchdog, to investigate the funding of GP co-operatives by local health trusts around the country. The co-operatives claim that they are being underfunded by about 10 per cent a year. 
Mark Reynolds, chairman of the association, said that the pressure on out-of-hours services had increased sharply: "We have had a lot of messages from managers and medical directors of co-operatives saying the health authorities are so short of cash they are trying to insist on cuts in spending on out-of-hours care. The service has already been squeezed considerably and they are now saying it needs to be squeezed even more. Doctors who choose to work out of hours will be under much more pressure and if they make it too unpleasant and stressful, doctors just won't show up." 
Dr Reynolds said that a co-operative in North Yorkshire had closed after a request for more money was rejected. He said the Government should issue guidelines on how much primary care trusts (PCTs) should spend on out-of-hours care. "It is important to remember we are providing a service of remarkably good value. If we can't provide the cover, people will use accident and emergency departments and that will cost the health service more." 
The trusts took over the responsibility of providing out-of-hours care at the end of last year after a large majority of GPs opted out of providing cover under a new contract. The trusts either provide the service in-house or outsource it to GP co-operatives or private companies. Around half of England is served by the co-operatives. 
The Government announced last week that PCTs would share £135 billion over two years. John Reid, the Health Secretary, said that the funding would go up no less than 9.2 per cent and would be targeted at frontline services and initiatives to prevent ill-health. He said that the money would also help to end regional disparities. 
Michael Dixon, chairman of the NHS Alliance, which represents the trusts, said that the cost of providing out-of-hours care had turned out to be more than expected, but said that he was confident that the funding problems could be resolved. 
"One of the most remarkable things about the PCTs taking over out-of-hours care is the fact there hasn't been any major problems. I do not think the quality of service has been compromised," Dr Dixon said. 
"The way forward for us is to work with the NAGPC and see how we can find a way forward that suits, most of all, co-operatives and PCTs trying to provide out-of-hours care." 
A Department of Health spokesman said that ministers had met NAGPC representatives and had asked for details of co-ops which face particular problems. "We will look into any examples where they feel that the quality of patient care on offer is not good enough. We regard out-of-hours services as being in good health," the spokesman said.


I'll give you 3 guesses where the patients are going to truck up to, we're seeing the trend already.  Perhaps some of the quasi acaedemics and others could advise?  
Best wishes to all the list

Danny McGeehan

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