Patients unable to see GP 'are clogging up A&E'

THOUSANDS of patients are abandoning their GPs and demanding treatment at hard-pressed A&E departments every year, according to Scotland's top emergency doctor.

Bill Morrison said "obstacles" put in the way of accessing GPs meant patients were turning instead to the "open door" of A&E departments.

Dr Morrison, head of the Scottish branch of the College of Emergency Medicine, said new GP contracts and the NHS 24 phone line were partly to blame for an extra 130,000 visits a year. Emergency doctors are already struggling with a big increase in their workload in Scotland.

A&E attendance has soared by 10 per cent in the past decade to more than 1.5 million patients a year.

The cost of the service has rocketed in the past three years by 30 million to almost 150m.

In recent years, GPs negotiated new contracts which let them opt out of out-of-hours working, and the telephone service NHS 24 was introduced.

Even during the week, family doctors are only required to provide an appointment within 48 hours. Dr Morrison, an A&E consultant at Ninewells Hospital, Dundee, said the changes had created "inequality of access" between GPs and emergency departments. He said: "A&E have an open door that people can access at any time. People are given a guarantee of being seen in four hours.

"Out of hours, you phone up NHS 24 and they take the details. You wait a period of time and then get instructions. If you are elderly or can't wait it is easier to attend an A&E department.

"Are people going to walk through the open door at A&E or go through the obstacles and hoops to see a GP?"

This means patients with non-urgent conditions such as sprains and rashes are potentially diverting attention from badly-injured accident victims.

Dr Morrison said: "I think we need to look at improving access to primary care. The capacity is there - it needs to be organised better. We have not got it right yet. There is no doubt that the new contract and NHS 24 have had an effect."

Murdo Fraser, Tory shadow health secretary, blamed the previous Lib-Lab coalition for the problem and urged the SNP government to take action.

He said: "Since the Labour Government at Westminster and the Lib-Lab coalition in Scotland introduced new GP contract in 2004, out-of-hours ambulance call outs have also rocketed.

"The UK Health Secretary Andrew Lansley is looking again at out-of-hours provision and how it could be improved.

"With better access to GPs, out-of-hours emergency attendances could be reduced and costs saved."

A Scottish Government spokeswoman said that two years ago GPs were offered new incentives to offer extended surgery hours and 70 per cent now did so.She said there were more than 23.5 million face-to-face appointments between registered patients and GPs and other healthcare professionals in the past year.

She added: "Most practices offer advice to patients about their out of hours provision and inform them about when and how to contact NHS 24, rather than the emergency services."