Fundamental questions

The newspapers are full of stories about out of hours emergency care in medicine. The renegotiation of the GP contract by the British Medical Association secured a position whereby GPs do not have to provide emergency cover between the hours of 6.30pm and 8am. The responsibility for providing such care rests with Primary Care Trusts.

If politicians reflect public opinion then there has been a noticeable backlash after an overseas doctor came to Britain to carry out some duties for a company set up to provide services to cover the out of hours emergency service. A patient died from a fatal overdose of diamorphine. The newspapers were quick to comment.

‘Inherent weaknesses’ in the vetting procedures meant that the doctor was allowed to treat patients despite the fact he had failed an English language test and had no experience of the NHS, an inquest found.

On Feb 16, 2008, working his first out-of-hours shift and ‘tired out’ after only arriving in the country the day before, a 70-year-old patient was given up to 20 times the recommended amount of diamorphine to treat pain in his kidneys.