Tory leader David Cameron has unveiled plans to renegotiate the GP contract so that local doctors regain responsibility for out-of-hours services from primary care trusts.

Announcing the move at the Conservative Party conference in Blackpool this week, Cameron claimed it would put patients at the heart of the National Health Service.

Many PCTs have not had the funds to commission access to GPs on weekends and evenings, he said, adding: “We will allow GPs to hold budgets on behalf of their patients, making them responsible for commissioning out-of-hours either through their own practice or, say, a GP co-operative.”

But Dr Laurence Buckman, chairman of the British Medical Association's GPs Committee said it is “sad” that the Conservatives have failed to understand the need for a new GP contract. “All sides recognised that the UK had too few family doctors. Recruitment was at an all time low, and doctors were thinking of taking early retirement because of the unsustainable workload. It was not safe to ask exhausted GPs to work nights and weekends as well as in the daytime,” he claimed.

“The real solution to the problem of out-of-hours cover is for Primary Care Organisations to fund the existing providers properly instead of continually trying to cut their budgets or attempting to find even cheaper private companies to run the service. The Conservative plan to turn the clock back will not help patients overall. It is likely to force GPs into leaving general practice and will do nothing to encourage doctors to replace them,” he concluded.

Government aims to expand services

Improving access to GP services is also at the heart of the government’s plans for the health service. Addressing the Labour Party conference last week, Health Secretary Alan Johnson hinted that surgeries may have to open their doors in the evenings and at weekends in order to make primary care more patient friendly.

Johnson outlined various measures to help deliver a personalised health service for patients as well tackle the inequalities plaguing the nation, including: more GPs in deprived communities; GP surgery opening hours at times that suit the patient not the practice; and high-street surgeries and increased pharmacist services to help drive primary care closer into the community.

But Dr Hamish Meldrum, Chairman of the British Medical Association, argued: “GPs are already working extremely hard to benefit their local populations and a recent government survey showed that well over eight out of ten patients were satisfied with access to their practices.”

Cameron insists, however, that patients do “not have a strong voice or sufficient influence over the provision of care they receive,” and other Tory plans to make the NHS even more accountable to patients include: allowing patients to choose a GP - whether close to home or work; simplifying urgent care; ensuring dignity and choice in end of life care; the establishment of HealthWatch - a consumer voice for patients; and scrapping top-down targets and political interference which distort clinical priorities.