By Marjory Inglis, health reporter

A DUNDEE GP has bemoaned the loss of vocational commitment amongst colleagues, and criticised the deal that allowed doctors to withdraw from round-the-clock responsibility for patients.

He suggests GPs who opt out of that responsibility should have more cash deducted from their practice payments to reflect the true cost of funding alternative services.

The doctor, who wishes to remain anonymous, spoke out following publication of the Audit Scotland report on out-of-hours services.

That report warned that services were “unsustainable” and showed the number of doctors working out-of-hours was falling.

It called for more nurses and other healthcare professionals to be trained to deliver services when family doctor surgeries are closed.

The Dundee GP said he did ad hoc sessions for the out-of-hours service and pointed out that work was “very adequately paid.”

When GPs were allowed to give up round-the-clock responsibility for patients four years ago, responsibility for delivering the service fell to health boards.

GPs can volunteer to work shifts in the out-of-hours service for an extra payment, though Tayside does cover a lot of the work with nurses and other health professionals.

The Audit Scotland report revealed that GPs working in the evenings and at weekends earn between £50 and £80 per hour.

GPs who gave up round-the-clock responsibility for patients had around £6000 each taken off the cash they get from the NHS for services to patients. The Audit Scotland report revealed that “clawback” was nowhere near enough to meet the costs of running alternative services.

The report pointed out that comparisons were difficult as services now were very different from those provided prior to opting out.

The Dundee GP said when the new GP contract was being negotiated the Government offered the profession the chance to opt out of its historical commitment to round-the-clock responsibility for patients.

“Not only did they offer this, but at a ludicrously low price for the shelving of this responsibility,” said the Dundee GP.

He said under the new system management numbers had spiralled, and costs were way in excess of the previous doctor-run out-of-hours systems.

“Out-of-hours work is now very adequately paid, but sadly there appears to have been a steady decline in the vocational sense of commitment that was very much a part of general practice not very long ago.

“I fear, particularly amongst younger female practitioners, with a few notable exceptions, when faced with a choice of time with their families or time with patients, they do not even make a compromise—it’s families every time.”

He said that historically doctors took a half day off to compensate for regular nights and weekends on call. Now they do not have this on-call commitment they still take a half day—“a 41/2-day week for well in excess of £100,000 per year.”

He suggested increasing the “deductions” from GP practice payments for those who opt out of round-the- clock cover “to something that reflects the real cost of providing this service.”