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The chair of the GP's council Dr Laurence Buckman has called for a proper review of the cost-effectiveness of parts of NHS Direct - we're guessing call centres - and changes to the Summary Care Record scheme.

Earlier this week it emerged that NHS Direct is moving to hire call centre managers with no medical experience. Currently about 41 per cent of staff are not medically trained. Plans would cut nurse managers to one in 39 staff, Pulse reports.

Speaking to the Local Medical Committees Conference, Dr Buckman outlined a list of things that should be "consigned to the dustbin of history". These included "wasteful PFI schemes, management consultants, the bureaucracy of the NHS market, management tiers that seem to exist to do little more than micromanage general practice, and patient surveys that provide no benefit to patients".

NHS Direct costs £123m a year and serves five million people who phone its call centres, and another five million who use its website. It deals with another five million calls in response to other services commissioned locally or nationally.

Nick Chapman, chief executive of NHS Direct, defended the service which he claimed pays for itself in stopping people from using other NHS resources instead. He said that more than half of all calls or visits to the website led to people treating themselves at home.

Chapman said: “There is evidence that NHS Direct more than pays for itself through the reduction in demand on face to face services. We have conducted analysis with our commissioner (East of England SHA), which shows that in 2008 we saved the NHS £162m by reducing demand on face-to-face services.

"This includes £106m through reduced demand on emergency care (A&E and 999), and in the order of £56 million on other primary care providers. This includes 1.7 million GP consultations that were avoided through patients calling NHS Direct."

All these proposed savings seem dwarfed by the £12.7bn being spent on the NHS's delayed IT programme. Or the millions the Department of Health also spends on consultants. In 2008 - 2009 DoH, excluding Connecting for Health which runs the technology programme, gave £12m to Ernst & Young, £9m to McKinsey and £4.9m to PA Consulting. Total spending on external consultants was £102m.

Buckman described the SCR scheme as "wrongly-consented - patients currently have to opt out if they do not wish to have their records uploaded to a central spine".

He also questioned the value for money offered by walk-in centres.

The service might not be liked by doctors but it is well-loved by patients, and those caring for the infamous germ factories that are young children. It also contrasts dramatically with the famously unhelpful phone manner of the traditional GP's receptionist.

Buckman's full speech is available here. ®

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