The death of Penny Campbell is a perfect illustration of failings in the new GP contract which were identified at the times it was signed.

What was lost when GPs were allowed to opt out of 24-hour services was continuity of care. Miss Campbell had had a minor operation, from which she contracted blood poisoning.

Any doctor should recognise that this was a possibility, albeit an unlikely one. But Miss Campbell’s own GP, aware of her medical history, would have been more likely to do so than a series of doctors employed by Camidoc, an out-of-hours contractor.

Even worse, the doctors did not have access to the same set of medical notes. Had they done so, or had only a single doctor and not eight been consulted, it seems much more likely the seriousness of her condition would have been recognised.

Out-of-hours care was not perfect before the new contract came in. Many GPs subcontracted it to deputising companies, while others shared it through co-operatives.

But an individual’s GP remained personally responsible for the quality of care delivered. This is no longer the case: now Primary Care Trusts are responsible for ensuring that out-of-hours care is in place and is of good quality.

Camidoc and the PCTs that employed it failed miserably on this occasion, which was over Easter. In retrospect Miss Campbell would have done better to turn up at the local A&E Department where she would have got better care.

Implementation of the GPs’ contract was rushed, and the terms agreed gave GPs no incentive at all to remain responsible for their patients 24 hours a day. By sacrificing just £6,000 a year of income GPs could spare themselves all the bother of calls at night and at weekends.

Those with a taste for night work could sign up with a company such as Camidoc and earn more than they had lost, with much less personal responsibility.

GPs wanted a better “life-work balance” but something important was lost from general practice when the change occurred. The old tradition of 24-hour responsibility may have been burdensome, but it was also admirable. With its abandonment the profession became more of a job, less of a vocation. Penny Campbell was a victim of the change.

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