27 May 2012

"GPs Quit remote area"

The Aberdeen Press and Journal gave us some first class support when we were fighting to take our battle over the loss of our Nurses to Holyrood. It was the same journalist, Catriona MacPhee, who wrote the front page article in last Wednesday's edition, titled, "GPs Quit remote area - with a swipe at NHS".

It was, once again, an excellent article, which made quite clear that our two GPs, Rob Colebrook and Simon Topham, are leaving the area at the end of August, not because they don't like it, or us, but because their workload has become intolerable. They cannot stay because they are expected to be on call, both for emergency and non-emergency cases, day and night, year-round, with little support.

At one time they had that support - in the form of our District Nurses Jessie Colquhoun and Carolyn Ellis who, because they could be called out at any time, did much to save the GPs travelling down the peninsula. Losing them has increased their workload, so they've quit.

The delegates from West Ardnamurchan Community Council who were involved with the year-long discussions with NHS Highland over the loss of our Nurses knew this would happen. After two meeting, the doctors stopped attending. Soon after that, they announced they were to stop non-emergency out-of-hours call-outs - but were never able to because NHS Highland dragged its feet over providing locum cover.

Prompt and decisive action by NHSH at that point might have kept our doctors here. What they should have done is what Gill McVicar, NHSH's local Director of Operations, says in her response to Catriona's article: "We are keen to work with communities to find innovative ways of... sustaining rural health and care services." But, throughout our year-long discussions with her, INNOVATION was the last thing she deployed. She imposed an existing system which worked across that part of West Lochaber which is nearer to centres like Fort William, but which does not, and continues not to work out here.

From the very start WACC said that we needed District Nurses based in Kilchoan covering work for NHS Highland, the Scottish Ambulance Service, and the local GP Practice. The idea was pooh-poohed as impractical. We would not, we were told, get anyone to do the job. We said we believed we could. A job description, agreed with NHSH some months previously, already existed. Yet NHS Highland refused to give the idea a chance - they would not, to use Gill McVicar's word, 'innovate'. The system, she said, would be 'unsustainable'.

Meanwhile, the reality on the ground out here is going from very bad to even worse. We had four Emergency Responders, and they were beginning to settle in, and doing a very good job. For the last few days we have been down to two - Jessie and Maggie. Both of the others are away; one, apparently, will be away for quite some time. The Scottish Ambulance Service said we needed a minimum of six ERs for the system to work. Two is certainly 'unsustainable'.

Something drastic has to be done, and quickly. When I was talking to NHS Medical Director Dr Bashford at the 'Drop-In' session ten days ago, I witnessed another local resident tell him, very very plainly that, unless urgent and imaginative action was taken quickly, there would be a tragedy out here. NHSH and SAS administrators cannot say they haven't been warned.


  1. Whilst one can sympathise with your current situation surely you must accept the comment your remote location cannot sustain, in the long term the type of medical cover you crave? It was after all your choice to live in such a remote, albeit beautiful area. Many similar locations predominate across the Highlands with neither the support nor the response you currently enjoy. Even with good road networks journey times over an hour are still commonplace. Is there an easy answer? Yes. Is that same answer really practical and cost effective given the workload of the peninsula? No, of course not. Nor should it be with even a modicum of common sense.

  2. Yet both our GPs have just quit, saying the workload out here is too onerous. As from August, we will have to rely on locums, which NHS Highland admit are almost impossible to get.

    Believe me, the situation out here is far from simple.

    1. Yes, I take your point. But the real issue is the 1 in 2 on call not the workload. If it was they could afford another partner. Perhaps its time to rethink the GP only strategy. The ‘Maris’ model is a thing of the past.