Last month the remote and rural community of Kinloch Rannoch voted overwhelmingly at a public meeting organised by the community council to reject local health board proposals for NHS privatisation. The meeting called instead for the restitution of their out-of-hours GP services, a right and entitlement they have had since 1948 but which they lost more than two years ago, despite protests.

The meeting marked the culmination of a two-and-a-half-year battle with Tayside Health Board about its failure to fill the void in out-of-hours provision as a result of the local GP opting out then retiring. In May 2006, the community, in the presence of the MSP John Swinney, demanded restitution of GP cover but promises to him made by the health board have been repeatedly broken and followed by delay and prevarication.

Now the health board has come forward with its preferred solution: "community resilience". The policy involves a company, First Response, supplying local volunteers to fill the gap the GPs have left behind by manning services with local residents/volunteers funded largely through community and charitable donations. Residents were told: "The company will operate a 12-person volunteer scheme with set-up costs of £15,000 funded through community and charitable donations". So local people are required not only to raise the funds, but also to provide the people to run core services provided by the NHS in most of the rest of the country.

But there is no evidence that a local volunteer with five days' training, and neither medical nor paramedic qualifications, can substitute for GP care. Indeed, the testimony of the ambulance men present at the meeting was that such volunteer services should be additional and not a substitute. In any case, how will a company supplying local volunteers deal with an acute subarachnoid haemorrhage, status epilepticus, anaphylactic reactions, the small child with meningococcal meningitis, the baby with acute bronchiolitis, the acute myocardial infarction of the acute trauma - the rare but life-threatening conditions that require swift diagnosis and intervention? Just how is the local forestry worker and petrol pump attendant volunteer with five days' training going to manage, and who will be liable when they fail to make the correct diagnosis and provide appropriate treatment and care?

Tayside Health Board says it cannot afford and hasn't the staff to provide full out-of-hours services to all. But the issue of providing care to small populations living in very remote and rural communities is not new - the NHS was founded to ensure that there was equal access for all and that small communities were provided for.

As the Royal College of General Practitioners and BMA will tell you, over the years payment systems and imaginative models of care and cover were developed and put together to ensure access and coverage to GP services. A recent parliamentary question from MSP Murdo Fraser revealed that out-of-hours GP cover is being provided in other remote and rural areas of Scotland. Highland and Grampian health boards are finding a way of providing GP care to 18 mainland communities. With the number of unemployed doctors and nurses rising, there will be no problem filling any gap in services in the future.

The erosion and removal of GP out-of-hours cover is part of a UK-wide story. The government in England brought in new legislation which allowed for the break up of primary care services and their commercialisation across the UK. South of the border, controversy is growing as US corporations and supermarket giants take over GP services and diminish citizens' expectations and entitlements to care. In July, Nicola Sturgeon, the Scottish Health Minister, received a standing ovation from the BMA when she promised to reverse this legislation and to keep general practice services in the public domain and out of commercial corporations, working to reintegrate all services in the NHS.

It appears that not all health boards are on-side in this matter.

Privatisation on the scale planned in Tayside is without precedent even in the far more market-orientated English health system. And it appears other health boards are also looking to First Response as an alternative provider of core NHS services, including East Dumbarton.

No citizen, let alone those in their seventies and eighties, should have to fight for what is their legitimate expectation and their right.

Since April 2006, the people of Kinloch Rannoch and in the remote Rannoch community have had no access to out-of-hours GP services; local medical cover for almost two-thirds of their lives is denied them. If the minister fails to step in and remedy this injustice, then tomorrow it will be the turn of us all.

Professor Allyson Pollock is Head of the Centre for International Public Health Policy at the University of Edinburgh.