Intended for healthcare professionals

Views & Reviews From the Frontline

Who’s to blame for overcrowding in accident and emergency departments?

BMJ 2013; 346 doi: (Published 07 May 2013) Cite this as: BMJ 2013;346:f2871
  1. Des Spence, general practitioner, Glasgow
  1. destwo{at}

The health secretary Jeremy Hunt blames general practitioners (GPs) for the overcrowding crisis in UK emergency departments,1 because GPs gave up responsibility for out of hours care in 2004. Is this fair? Before 2004, GPs had 24 hour responsibility for patient care. General practice has always been hard work, but demand and expectation were increasing unsustainably in the 1990s. Middle aged GPs (without the protection of junior staff) were often up through the night yet working the next day. Compared with hospital colleagues, the pay and status were poor. GPs were hugely undervalued. General practice was in crisis, with talk …

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