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GPs warn of threat looming for rural patients

FAMILY doctors have warned that patients will suffer unless action is taken to address a crisis facing GPs in rural and remote areas.

CHALLENGe: David Hogg says it is not uncommon to work 24 hours when on-call gets busy. Picture: Chris Hogge
CHALLENGe: David Hogg says it is not uncommon to work 24 hours when on-call gets busy. Picture: Chris Hogge

The Royal College of General Practitioners (RCGP) says there is a risk GPs will become unable to offer a safe service.

The body, raising its concerns in a new policy paper, said a lack of broadband and mobile data services rendered many innovations championed by the Scottish Government useless in non-urban parts of the country, while a lack of interest in becoming a GP had resulted in a recruitment crisis in isolated communities.

The RCGP found that some doctors were forced to be on call 24 hours a day, meaning their own family lives were suffering, while others faced social isolation.

The college has backed a series of new measures to address what it sees as a deepening crisis, including moves to promote the image of general practice and the benefits of being a rural GP, improving links between rural communities and medical schools and making changes to the application process to universities to make it easier for those from remote areas to win places on courses. A significant boost in funding is also necessary to allow GPs to deliver the increasing demands being placed on them, it is claimed.

Miles Mack, RCGP chair-elect, said: "We are concerned that in some areas, patient care is going to increasingly struggle, and patients aren't going to get the services they need when they need them."

The plan is for 95 per cent of Scotland to have access to broadband by 2018. However, the RCGP said that many GPs were struggling now.

Health Secretary Alex Neil has repeatedly spoken about the benefits of new innovations in healthcare, but Dr Mack said the cut-off areas were stuck with antiquated systems, with it taking minutes for some GPs with shared sites to print off a prescription. Accessing patient records digitally could also prove challenging.

"We are increasingly dependant on computers and information technology," he added. "We're being told it's great to get advice and support from elsewhere but without video conferencing you can't do that.

"Smartphone capabilities fail in a great deal of rural areas, as there's no data service at all. Then there's mobile connectivity - how do you call an ambulance if your phone doesn't work?" A serious recruitment crisis needs to be addressed, Dr Mack said. Some health boards have to rely on expensive locums, who may not have the appropriate skills to run GP services, as they cannot attract permanent staff to rural locations.

More funding is needed too, the RCGP believes. While the amount received by primary care services has increased in recent years, it has not kept pace with the total NHS budget. Plus, the number of annual GP consultations in Scotland rose from 23.2 million in 2008 to 27.6 million in 2013 - expected to hit more than 31 million by 2017.

The Scottish Government accepted there were issues but said it was committed to supporting GPs across Scotland. A spokesman said: "We know that some health boards face significant difficulties recruiting in remote and rural areas. In the Highlands and Islands there are some particular communities that have been without a permanent GP for a while, and the Scottish Government completely understand how frustrating this is for residents.

"The changes to the GMS contract negotiated for 2014/15 will mean that health boards have flexibility to specifically incentivise GPs to work in those areas that are more difficult to recruit to."

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