Okay. I invite Rhoda Grant to come in at this point, as she has been working with the campaigners.
Rhoda Grant (Highlands and Islands) (Lab):
As members know, I cover the Highlands and Islands, and this is a really big issue in my area, given the number of rural GPs. I do not have the figures with me, but I understand that when rural GPs were polled, most were against the contract, with only a very low number supporting it.
The new contract does not recognise the differences in how people operate in rural areas. For example, there can be higher numbers of home visits, because people are being kept out of hospital. Instead of elderly people being sent away, they get more hands-on care. Moreover, GPs are responsible for local hospitals in places such as Campbeltown and Golspie, so they have additional—and specialist—work that is not recognised in the contract. The way in which the contract was drawn up has really impacted on the morale of rural GPs, who often work above and beyond and do not feel that they are valued.
The contract also flies in the face of the work on tackling the health inequalities that we all recognise. It is working neither for rural areas, nor for deprived urban areas. Because it looks at the number of appointments that are available and at the age profile of patients in a practice, the 10-year life expectancy gap that we all know can exist in deprived areas means that those practices are getting less, given that their patients do not live as long as patients in other areas. The contract seems to have moved funding in a direction opposite to the one that it was understood that funding needed to move in.
To that extent, the whole contract needs to be looked at, but it certainly needs to be looked at with regard to rural GPs, given our struggle to fill posts. If the contract goes unchanged or there are no additional deals for rural practices, the situation will get worse, and the cost of locums is already extremely high for rural health boards.