We regreted to inform patients that the responsibility for providing medical services "Out of Hours"  was taken away from GP surgeries in 2004.

GPs were responsbile for on call services to our own patients evenings and weekends  Out of hours includes ALL weekends, bank holidays and 6.30pm to 8am every day.  

From 1^st October 2004 out of hours medical services for Archway’s patients has been provided by Dacorum PCT, now West Herts PCT, using a company called Harmoni in this area.

In 2007 there was correspondence about out of hours services, including this Letter to The Times

The Government's idea in setting the new out of hours system up was to create two primary care services. The Out of Hours Services would also do in-hours services, and thus provide competition to general practice.  Continuity of Care is seen as a bad thing.

80% of the Profession (now 40% part timers), agreed in a poll to give up being responsible for out of hours services. That was a huge mistake (never give up a monopoly). It also broke, in my view, the "buck stops here" of  General Practice. G.P.s were responsible 24/7/365. If anything went wrong, even if the patient was attending hospital outpatients, or anything went wrong out of hours the patients could point the finger at us, since we were responsible for the patients on our list. It meant that G.P.s were irritating advocates on behalf of the patients they were responsible for.

Locally G.P.s formed a co-op DacDoc to do on call.  We all took it in turns to be on-call. We were responsible for the service but did not necessarily have to do it...we could contract it out.
The Government has also scrapped registering patients with a doctor, again to break the patient/doctor link, so you now register with an organisation or practice....not with a doctor. You register with a "team" so nobody is seen to carry the can. Doctors are moving from a profession to a trade.

In 1948 G.P.s were not nationalised as the Government of the day could not afford to buy GP premises. The 2004 Out of Hours contract was a form of nationalisation: the care of patients for 3/5th week was taken  from G.P.s and passed it to PCT contracts; no property or goodwill purchase required. Very clever.

This new system came with the new contract.  Those G.P.s who wished to carry on and run out of hours cover for their own patients, either directly or on groups, were prevented from doing in most parts of the country  by new rules and regulations (such as G.P. having translation services and phone conversation recording). The costs were set such that G.P. would have lost out if they attempted to keep out of hours.

While some G.P.s "opted out" of being responsible for out of hours cover, many of us were forced out.

As it happens the Government's plot may not working out. The Out of Hours  provision is proving VERY costly, and rumours are that the Government may offer it back to G.P.s  to be responsible (and perhaps contract it out) once more.