Under the general medical scheme, participating doctors are required, as per the contract, to be routinely available for consultation for a total of 40 hours per week on five days or more by agreement with the health board. Within this framework, contracted doctors enjoy significant flexibility in determining their precise scheduled surgery hours.
The contracted doctor is also required to make suitable arrangements to enable contact to be made with him or her or a locum-deputy outside normal hours for urgent cases. Traditionally, this has been realised through rota, deputy or bureau arrangements between doctors which are usually organised by the individual contracted general practitioners themselves on a mutually agreed local basis.
Broadly speaking, the development of the out of hours general practitioner co-operative can be viewed as a voluntary and highly effective rota system structured, and supported by public funding, to maximise appropriate out of hours service provision to patients in a way that also allows participating doctors to best plan their involvement. In that regard, it gives rise to no particular issues that would necessitate separate contractual arrangements and, accordingly, I would be very surprised if any doctors, individually or collectively, were to seek to represent the out of hours co-operative concept as having contractual implications justifying special arrangements.
Currently, the general practice out of hours co-operatives are being piloted in the SEHB, CAREDOC, and NEHB, North East Doc, areas. I am aware that other health boards are interested in developing these models in their regions and it is my intention that, on the basis of experience gained from the pilot projects, my Department will progress the expansion of the co-operative models to other boards in 2001. Indeed, some preparatory work is already under way within some boards in that regard.
I should conclude by stating that it is already clear from the pilots that while all projects will understandably have some regard to local factors in their development, the expansion of these schemes must also be subject to ensuring that they comply with certain general principles of good practice, for example, the use of contracted doctors rather than locums, if they are to justify the public funding involved in their operation.
