The article by Simpson and Esmail in the March issue of the BJGP gives only two solutions to the provision of out-of-hours care, asking doctors to take it on as a duty or to pay more for it. Perhaps one reason why some of us do not do out-of-hours care is because the in-hours pay means we do not have to. Our colleagues on the continent earn far less. For many, out-of-hours pay at ￡45 would seem a very generous wage. Perhaps other avenues, like making it essential for revalidation, as in Holland, may make this an essential part of patient care better resourced by local doctors.
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