The public must decide what sort of service it wants

General practitioners' recent rejection of the government's proposals for out of hours care1 and the heat of the debates at the midsummer conference of local medical committees2 show that the issue has become a leading preoccupation for doctors. Yet out of hours services are not mentioned in the NHS Executive's Priorities and Planning Guidance for the NHS: 1996/73 or in Renewing the NHS: Labour's Agenda for a Healthier Britain.4 No wonder general practitioners think that both politicians and senior managers are out of touch with their concerns.

Since 1948, general practitioners have assumed responsibility for the care of their patients 24 hours a day, 365 days a year. They are not obliged to deliver all of that care themselves, but they are responsible for making …