Please send me SCA's fortnightly briefing:

September 24, 2008

How far can community self help go?

The local health board responsible for the remote rural community of Kinloch Rannoch thought the solution to local GPs opting out of providing out of hours emergency cover was to train up local people as first-aiders. The health board chairman thought the proposal would reflect ‘community resilience’. The community saw it differently and called it a ‘dereliction of duty’

Marilyn Murray, Rannoch, Perthshire. – The Herald, Letters to Editor

Community resilience? More like dereliction of duty in Rannoch

A recent article in the Herald by Professor Allyson Pollock demonstrates conclusively that, despite Scottish Government promises to keep primary medicine, and particularly GP practice, within the public domain, the very opposite is being allowed to happen in remote and rural areas of Scotland to the detriment of those who live there.

Kinloch Rannoch is a case in point. A fully equipped, fully manned medical centre is positioned in the village to serve the needs of this remote and rural community, along with a local school and a local fire station. But inexplicably the local GP practice was allowed to opt out of providing any out-of-hours emergency service and since then, because the Rannoch area is beyond ambulance cover within acceptable time limits from either Pitlochry or Aberfeldy, lives have on a number of occasions been put at risk. The present setup, with none of the local GPs being prepared to give emergency cover, is palpably unsafe and cannot continue.

But what does the local health board propose? The chairman has stated that “local access to an emergency care service does not necessarily have to be provided by a GP on call 24 hours a day”, and he wants instead to train up first-aiders to come out at nights and over entire weekends instead of doctors. He calls this “community resilience”! People in Rannoch call this dereliction of professional duty.

As Professor Pollock points out, this so-called “First Responder” model, which is being specifically proposed to replace the GPs in Rannoch, is both a breach of NHS’s core principle of continuity of care and a denial of the human rights and legitimate expectation of the resident population to all-round GP care which is provided elsewhere in the Highlands and islands of Scotland. Rannoch should be no different.

Fortunately, Rannoch residents have refused to accept an inadequate substitute for their GPs and have stated so in packed protest meetings.

Professor Pollock’s intervention is welcome, but Nicola Sturgeon must now intervene to prevent the residents of Rannoch being fobbed off with a third-world medical service that is unacceptable to them.