I worry when all this blame rears it's ugly head. GP's are getting flack for big wages, opting out of out of hours, poor accesss to in hours appointments etc etc etc... I know lets shift the blame and use the reliable back up of the smoke screen that is Blame NHS Direct. Surely there has to be some common sense engaged here. IF In hours GP surgeries had better access to the patients.. If patients actually listened and did as they were advised ... Took some responisbility for themselves when minor ailments hit. that would take the pressure off some area.. But as one who works in OOH telephone triaging calls I can vouch for the fact many many caller tell lies to get access to the service and on occasions they may oversell themselves " yes I have gripping central chest pain, it is going to my left arm and neck, I feel sick and sweaty!!!" when actually when the paramedics arrive they profess to have only had a slight pain a few hours before the call.. Why oh why are we in the NHS insistant in slagging off each other... why don't they get together and sod the politicians.. let us work out a reasonable strategy to hand all such problems.. GP surgeries during the day often orchastrated by the rockwieller receptionist tell patients to call NHSD for assessment during the day to see if they really need an appointmenty. or as I often hear direct the patients either to call 999 who redirect category C calls to NHSD. Or tell them to wait until after 18.00 to call ooh and tell them they need an appointment.. Who is abusing the service here then?? I symathise with the NHSD staff.. if they direct to self care and a patient dies.... they are heading for a FAI inquest with no support from their own employer on the otherhand when referring the patients are targetted by the GP's Who incidenlty were the ones the service was set up to cover their backsides since the new GMS contracts were in the offing...