Privatised out-of-hours care will put patients at risk, warns GP who worked for Britain's largest care agency Dr Fred Kavalier claims he told doctors in 2010 that he had concerns about care provided by Harmoni Two years later baby Axel Peanberg King died following 'inadequate' decisions made by Harmoni doctor Harmoni refutes suggestion that concerns have not been fully investigated Warning: Dr Fred Kavalier told four directors of Harmoni in December 2010 of his urgent concerns. Two years later Axel Peanberg King, pictured with his mother Linda, died A doctor who worked for England's largest independent provider of out-of-hours care has warned standards are so poor patients are being put at risk. Dr Fred Kavalier claims to have told four directors of Harmoni in December 2010 that he had an 'urgent concern about the quality and safety of the service Harmoni is providing.' Two years later, baby Axel Peanberg King died following 'wholly inadequate' decisions made by an out-of-hours Harmoni doctor based on a one-minute phone call. Dr Muttu Shantikumar ignored the pleas from Linda Peanberg King for her seven-week-old son, who was suffering from pneumonia, to be seen as soon as possible, an inquest last week was told. He downgraded her call from "urgent" to "routine" and left her waiting for nearly four hours for an appointment because he did not deem the baby's situation an emergency. With her dying son in her arms, the 35-year-old mother, from Islington, London, then had to wait in line behind six non-emergency patients at the private out-of-hours GP service Harmoni, at Whittington Hospital in Archway, north London. St Pancras Coroner's Court heard that it was only when an off-duty nurse spotted that Axel had turned "grey and floppy" that he received emergency care - but by then it was too late and he died at the hospital from bronchopneumonia five days after falling ill. Recording a narrative verdict, Dr Radcliffe described the brief phone conversation between Dr Shantikumar and Mrs Peanberg King as "wholly inadequate," adding that the doctor "asked insufficient questions." Harmoni have released a statement saying the coroner was clear that she found no evidence of systems failure in the Harmoni service Dr Kavalier says Axel's death was the kind of incident he was trying to prevent when he sent the letter to directors. Speaking to the Independent on Sunday, he said: 'It is what happens when services are fragmented and commercial interests become more important than patient care. 'Despite Harmoni's claim they treat patients 'like family' in reality they treat them like rail passengers.' Harmoni have released a statement saying the coroner was clear that she found no evidence of systems failure in the Harmoni service. It said it was not possible to totally eliminate the possibility of an individual's error or misjudgement. Dr David Lee, medical director for Harmoni, said: 'I can confirm that Harmoni responded fully to Dr Kavalier's concerns and our communication was sent by both email and recorded delivery letter on March 11, 2011. We shared his concerns with both the PCT commissioners and the local medical committee (LMC). Harmoni refutes absolutely any suggestion that concerns raised by any clinician, patient or commissioner have not been properly and fully investigated. 'The coroner's comments relating to the tragic death of Axel Peanberg King confirmed that there was no evidence to suggest that Harmoni staffing levels were unsafe. The coroner also stated she was satisfied Harmoni has made considerable efforts to ensure the competence of the GPs working in the out of hours service and that Harmoni had plans in place to ensure this process is ongoing including improving paediatric training for all its GPs. The coroner was clear that she found no evidence of systems failures in the Harmoni service. Harmoni was founded by five London GPs in 1996 and was bought last year by Care UK for £48million. Last year it turned over £100m and has won more than a quarter of the contracts for the new 111 non-urgent phone line. It is not the first time private out-of-hours care has been scrutinised. Dr Daniel Ubani was working for an out-of-hours medical service in Cambridgeshire when he mistakenly gave 70-year-old renal patient David Gray ten times the safe dosage of diamorphine. Coroner William Morris ruled the death was "gross negligence and manslaughter" and Ubani was struck off by the GMC in Britain.