The article by Simpson and Esmail in the March issue of the BJGP gives only two solutions to the provision of out-of-hours care, asking doctors to take it on as a duty or to pay more for it. Perhaps one reason why some of us do not do out-of-hours care is because the in-hours pay means we do not have to. Our colleagues on the continent earn far less. For many, out-of-hours pay at £45 would seem a very generous wage. Perhaps other avenues, like making it essential for revalidation, as in Holland, may make this an essential part of patient care better resourced by local doctors. Or should we hand in the towel and accept that this service cannot be provided in the face of 24-hour choice and let the 999 services take the strain (and cash)?
- © British Journal of General Practice, April 2011
