Two hundred London doctors have sent an open letter to England’s health secretary, Andrew Lansley, the capital’s mayor, Boris Johnson, and local MPs to protest at the transfer of a local, GP led out of hours service to a private contractor.

The letter’s signatories, who include doctors working for the service, Camidoc, and some who use it, claim that the decision to hand over out of hours provision to the for-profit company Harmoni will increase the cost of care and that safety and quality may be put at risk.

They also claim that the main reason given for the move—Camidoc’s financial viability—was largely created by the consortium of commissioning primary care trusts (Camden; Islington; City and Hackney; and Haringey) that chronically underfunded it.

Harmoni, which was awarded a nine month interim contract in July and started operating on 1 September, provides emergency care and out of hours services to more than nine million patients across England.

A briefing posted last week on the website of the lead primary care trust, NHS Camden, said that Camidoc had emerged in March as the …