Published: 15/07/2004, Volume II4, No. 5914 Page 7

Primary care trusts are likely to find themselves facing£500,000 deficits because of the cost of running new out-of-hours services, the Commons health select committee has been told.

Giving evidence to the committee, West Hull PCT chief executive Dr Graham Rich said: 'Because GPs from the end of this year will be able to opt out [under the terms of the new general medical services contract], We have got problems.We have had to find£500,000 to meet obligations at market rates.'

His views were echoed by East Anglia Ambulance trust primary care development manager Lyn Reynolds. Speaking after the committee hearing, she told HSJ: 'I do not think that the Department of Health appreciate the cost of out-of-hours [services].

'We reckon that each PCT will have to spend around£500,000 over what it receives for outof-hours.'

Dr Rich said that in future around 60 per cent of out of hours work would be done by nurses and emergency practitioners, following the changes introduced in the new GP contract.

Ms Reynolds estimated that it would take around three or four years to recruit and train these staff. However Dr Rich and NHS Direct chief executive Ed Lester calculated it would take 'slightly less' time.

Other experts agree that budgets will be overstretched.

National Association of GP Coops chair Dr Mark Reynolds gave evidence to the committee at the end of June.

He calculated that PCTs would be between£200,000 and£300,000 out of pocket as result of the changes. And he estimated that it would take at least three years to get the right skill mix.

Peterborough PCTs chief executive Chris Town said that if PCTs did not change their staffing methods, they could easily face deficits of£500,000: 'We are currently training paramedics and nurses to do out of hours work.

We are training them on the job and we expect the process will take at least two years.'