Family doctors no longer have to provide out-of-hours services

The British Medical Association said there had been a "breakdown in communications" over an agreement with Chepstow Community Hospital.

Gwent Healthcare Trust said there would be no cut in services to patients and the GP ward was at no risk of closing.

The local MP wants the health minister to intervene, after he was contacted by patients' families and staff.

At the heart of the problem is the new UK-wide contract for GPs under which they no longer have to provide out-of-hours cover.

We don't think it's reasonable to expect us to remain on call for in-patient and minor injuries attendance Dr Richard Jones

BMA Wales said it had wanted the Welsh Assembly Government to negotiate the terms in Wales for community hospitals to ensure that services would continue.

But the assembly government said it never promised to negotiate pay levels throughout Wales and that it was a matter for local trusts.

Responsibility for ensuring there is sufficient out-of-hours cover for patients fell to local health boards from the start of September.

The group of family doctors in Gwent had hoped to negotiate an agreement with Gwent Health Care NHS Trust, which runs the Chepstow hospital.

The GPs are able to admit their patients directly to the hospital and care for them themselves.

Responsibility for securing out-of-hours cover lies with NHS trusts

Dr Richard Jones, chairman of the local GP committee for the hospital, said the dispute was not primarily about money - although this was an element - but about the failure to negotiate acceptable working conditions.

He said: "We don't think it's reasonable to expect us to remain on call for in-patient and minor injuries attendance. It makes a nonsense of the new nationwide contract.

"I do feel the BMA in Wales was on the right track when they tried negotiating nationwide terms and conditions of service that could have avoided what I feel will be protracted local disputes.

He said the BMA had put forward proposals and the assembly government had responded to those.

"But there has been no pressure on the trusts to adopt what the assembly put out - it wasn't particularly acceptable to doctors anyway - but there was negotiation available, which really hasn't progressed through to satisfactory conclusion."

'Local populations'

Gwent NHS Trust said the role of the GPs would be carried out by hospital doctors, led by a consultant.

Sian Millar, general manager for community services in the trust, said: "We all accepted that the existing arrangements were outdated and we agreed to give the doctors a proposition outlining the level of cover needed at the hospital in the future.

"This was based on the changing needs of our services, with flexible working sessions aligned to all other doctors like them who are employed on a part-time basis in our hospitals."

The assembly government said: "At no time in any discussions has the Welsh Assembly Government ever confirmed that we would be negotiating the national rates of remuneration at a national level.

"The minister has confirmed that she wanted nationally agreed principles to be included in a framework so that a consistent approach would be applied across NHS Wales in respect of GPs working in community hospitals and their remuneration.

"Trust chief executives in Wales will accept this national framework to guide them in achieving meaningful local negotiations which take into account local circumstances."

"Local people who have relatives or friends in the hospital and staff who work in the Health service have contacted me about the situation.

However, Huw Edwards, the MP for Monmouth, said he had written to Health Minister Jane Hutt, asking her to resolve the situation.

"Chepstow Community Hospital was the first new hospital opened under the Labour Government in Wales and is a credit to all those who campaigned for many years to have updated health service facilities in the town," Mr Edwards said.

"It is therefore a great pity after years of operating with much local support that the hospital now faces a difficult time with its relationship with its local GPs," he added.