Out of hours GP cover is not in the best of health

10 February, 2010

AT recent meetings of the health and sport committee we have been looking at out-of-hours health cover in rural areas.

Much of this was done in the parliament but we also went out to Kinloch Rannoch in Perthshire where the community had been experiencing problems with their GP cover and felt that the health board had not been taking this seriously.

What is beginning to emerge is that each community has a different level and expectation of cover depending on what they have had in the past.

What isn't in place is an indication of what people should receive as a minimum or indeed the cost of that to health boards.

The GP contract was changed for GPs who run private practices.

In reality this is the vast majority of GPs, very few are salaried by the health board.

The contract was changed because the British Medical Association, the biggest trade union for doctors, advised that fewer of their members were willing to take on remote and rural practice because of the unsocial hours.

The contract was changed to allow them to opt out, with only a small reduction to their pay.

What became clear during evidence is that the rural GPs who were supposed to be unable to carry on have carried on because there is no alternative to provide safe services for their patients.

Those who have opted out can provide out of hours for a few nights a year to recoup their losses and leave others to fill the gap.

In the Borders they have dealt with this by employing many GPs, some to provide surgery services and others to provide on call - both working together to ensure that their skills are kept up to date.

This seems a reasonable solution to me.

The costs of being on call ranged from £10 per hour to £150 per hour depending on "the market", which is a wholly unsatisfactory way forward.

It should not be left to individual health boards to find the solution - the Government has a role.

I'm looking forward to drawing up our report and presenting it to the Government in the hope that this terrible situation can be rectified.

This article was first published in the John O’Groats Journal