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Unlawful killing verdict is a wake up call to the NHS

February 4, 2010 1:45 PM
By Charles West

Local GP, Dr Charles West commenting on today's verdict on the death of David Gray said,

"The NHS needs to learn some lessons from this, and learn them fast. Quality care cannot be done on the cheap, and the government's obsession with chasing competition from private firms is putting cost before patient care.

"The out of hours care service that killed David Gray, and was also involved in the death of nine month old Taylor Smith had some key features that should have rung the alarm bells.

  • It is private company brought in by the Local Primary Care Trust (PCT) to provide out of hours care.
  • It had been criticised by local GPs over mistakes in prescribing diamorphine in the weeks prior to the death of David Gray.
  • It was know to be facing financial pressure.
  • It employed fewer doctors than most out of hours services, sometimes as few as 2 doctors to cover 600,000 patients.
  • It recruited doctors from outside the area. Dr Urbani who gave the overdose of painkiller to David Gray flew in from Germany, was not familiar with British General Practice and had poor command of the English language.

"In addition both the coroner in this case and the NHS Care Quality Commission criticised the supervision of this company by the PCT.

Dr West Continued,

"In my view the PCTs will always find it extremely difficult to define all the requirements of a high quality out of hours service, and almost impossible to monitor it to a level that guarantees a safe service.

"In contrast to the private firm implicated in these deaths, ShropDoc is run by local GPs, is staffed by local GPs. It has between 6 and 9 doctors on call to cover 600,000 patients. It makes no profits and pays no dividends to shareholders. It does not fly in doctors from a distance. We are fortunate in Shrewsbury to have a first class out of hours service."


The new contract for GPs introduced in 2004 allowed Practices to pass responsibility for out of hours cover back to PCTs. Around 90% of GP chose to do so.

PCTs in some parts of the country (including Shropshire) continued to employ the local GPs working in a cooperative to provide the out of hours service. In some parts of the country PCTs negotiated contracts with private companies to provide the service.

Take Care Now is one such company. They proved services in the East of England and in Worcestershire. They have recently lost some contracts in the East of England.