There are serious concerns over a health board’s controversial plans to reduce the number of remote communities which still receive emergency cover from a nearby GP.

The board of NHS Highland has decided its “direction in travel” to enlarge geographical areas covered by doctors, because of the difficulty in attracting GPs to the Highlands. This has led to an increase in costly locum cover for often comparatively few call outs. The move is set to have a direct impact on five of the 22 locations which still enjoy locally-based out-of-hours GP cover

The communities earmarked to lose out are Lochaline in Morvern; Glenelg in Lochalsh; Applecross in Wester Ross; and Lochinver, Armadale and Tongue in Sutherland. Cover is to be provided across larger areas.

According to a paper which went to the NHS Highland Board: "There are not enough GPs to staff the number of sites we have historically staffed. This will get worse in the coming year, which if not addressed, will lead to unplanned service failure. The situation in areas of higher population density is now grave and contingency plans have had to be put in place on a regular basis."

It said that nursing and paramedical professions were now widely considered to have demonstrated an ability to play a key role in urgent care provision, working in conjunction with GPs.

However Dr Michael Foxely, a member of the health board and a former GP and Highland Council leader, expressed his concerns.

John Maclean, co-chairman of Glenelg and Arnisdale Community Council, said "There is no doubt that the level of medical cover is going to be dramatically reduced and everybody is extremely perturbed about the situation.I think the community would want to revert back to a permanent medical practitioner based in Glenelg."

Skye, Lochaber and Badenoch SNP MSP Kate Forbes acknowledged that the health board faced problems, but said: “The proposal for reducing out-of-hours locations, which particularly affects Lochaline and Glenelg in my constituency, is deeply unfortunate.

“I am sincerely concerned by any reduction in medical cover in rural areas, although I understand that the decision is based on a critical challenge facing NHS Highland of recruiting GPs and the current variation in local practice. NHS Highland is spending a small fortune on locum cover, which is directing money away from patient care elsewhere.

“I was staggered to learn that 25 per cent of all doctor time in the out-of-hours period is in the Highlands and so there is clearly something that we could learn from elsewhere in Scotland, particularly rural areas.”