Letter: Medical turf war

I write to respond to comments made by Dr Bill Morrison, chair of the Scottish branch of the College of Emergency Medicine, regarding out-of-hours care ("Patients unable to see GP 'are clogging up A&E'", 3 November).

It is wholly inappropriate to suggest that it is difficult to see a GP during out-of-hours periods and it is untrue to suggest that the GP contract is responsible for any problems in emergency departments in Scotland.

Any patient who needs to see a GP during the evenings and weekends will do so if they contact NHS 24 with concerns about their health. Following the introduction of the new GP contract, almost half of all GPs continue to deliver out-of-hours care and in many areas of Scotland the systems that operate now are the same ones that operated before the contract was introduced.

Demand for emergency services - A&E, NHS 24 and ambulance services - is increasing. A recent Audit Scotland report showed this was not the result of the new GP contract (Dr Morrison was a member of the advisory group to this report).

To identify how best to manage this increase, it is important to take steps to understand why demand is rising.

I would urge Dr Morrison to consider a more productive approach to improving the problems that exist in out-of-hours and emergency care in Scotland. The BMA advocates much closer working between service providers, including NHS 24, the ambulance service, A&E and GPs, in local areas where the ability to review any failings in the system can be managed proactively.

Surely it is in everyone's interests to work together to resolve this for the benefit of our patients and not start a turf war in medicine.

(Dr) Dean Marshall

BMA Scottish General Practitioners Committee

Queen Street

Edinburgh