The medical crisis in rural and remote areas

[hoots the scoop]

Interesting letter in The Herald last week - which GP recently resigned?

The medical crisis in rural and remote areas
THE population of Campbeltown have within their midst the near-perfect out-of-hours centre in the local community hospital. Patients can simply attend or be brought in by ambulance where their medical needs will be dealt with by appropriately trained staff.
Following the recent resignation of one of the five GPs who provide this 24/7 service, the remaining four have a difficult time ahead. Over the past 10 months we have been trying to recruit an additional GP, alas with no success. Why, you may ask.
The principal reason is that GPs no longer wish to work 24 hours "on call", often then working the following day. Our job may be interesting and challenging, managing acute medical and A&E cases. The pay-off is the impact on family and personal life.
The new GP contract relating to out-of-hours care has failed remote and rural areas. We cannot opt out. By allowing all GPs the right to opt out, recruiting to a practice which must continue providing 24/7 out-of-hours care is becoming increasingly difficult, thus undermining the sustainability of the medical service in the area. Had the out-of-hours negotiating committees considered remote and rural areas carefully, it would have become clear that the out-of-hours model for urban areas did not fit remote areas. Why should some GPs walk away from all out-of-hours responsibility while others have no choice but to continue providing 24/7 care?
If all GPs under the age of 55, as part of their contracts, were to provide at least some out-of-hours sessions, perhaps then places like Campbeltown would be successful in recruiting new GPs, thus enabling medical care to continue for the population.
NHS 24 in its present form has failed to provide an adequate service despite costing more than £50m a year. The Scottish Executive must rethink the entire out-of-hours service. Unless this happens soon, medical care in Campbeltown and similar remote and rural areas is not sustainable.
Dr Michael D Hall, Campbeltown Medical Practice, The Health Centre, Campbeltown.

[/i]

[mary,queen of everything]

As a local, currently temporarily exiled in a small rural community in the middle of the US, and working in US health care for over 30 years, we have many of the same problems. Locally we have about the same mix of agriculture to industry as C,town and 6 GPs to cover. Nearest large hospital is 110 miles from us. What we do is rotate the night call so that the Doc who is on at night has the next day off. On most weekends we bring in a Physician from a Physician rental company( very well paid) and he or she works from Friday night to sunday at 5pm when a local GP then takes over untill 6 am the following morning when another of the locals take all the emergency calls. Our Docs do not go to homes, all patients are seen in the medical clinic or the Emergency rooms.
Home visits are by a visiting Nurse group at our hospital and if warranted the patient is then moved to the hospital for more definative care.
If a Doctor retires or moves out of the area it creates an increased work load for all the others and when flu season hits its pure bedlam. However I still prefer the small local community hosp over some of the giants I have worked at. The big Hospitals have an average ER wait time for non emergent care of about 8 hours depending on area, the major problem with our rural areas here is finding things for the wife/ husband to do.
MQOE