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Last Updated:  Friday, 21 February, 2003, 12:05 GMT
Rural GPs await change
Dr Bob Dickie
The way GP practices work has not changed since the 1940s
Rural doctors like Bob Dickie hope plans for a radical overhaul of GP contracts will see an end to 100-hour working weeks.

The Group Practice in Stornoway, where Dr Dickie is a partner, tells a typical story of pressure on time and scarce resources.

"The regulations we currently work under were drawn up in the 1940s when it was apparently acceptable for people to work 24 hours a day, seven days a week.

"But now it is unacceptable for someone to work 12 hours a day without barely a break for lunch, let alone out of hours working," said Dr Dickie, a GP for the last 25 years.

The changes, proposed by the government, are part of a multi-million pound pay offer for GPs, designed to stop them leaving the NHS and to encourage others to take up posts.

'Fantastic job'

Under the deal, GPs will no longer have to provide care to patients in the evenings or weekends.

In return, they will be expected to improve the care they provide to patients during the day.

Dr Bob Dickie
Dr Bob Dickie has been a GP for the last 25 years
The proposals are detailed in a massive document which Dr Dickie said needed "consideration".

The GP is particularly interested in what plans are in the pipeline for out-of-hours working.

He said: "Most weeks I am working an average of 100 hours for the NHS, in some weeks it can be 120 or 130 hours.

"Out of hours is a major consideration because of the effects it has on lifestyle and I know a lot of rural doctors are hanging in there waiting for something to happen so that their hours can be addressed."

Despite the challenging working hours, Dr Dickie said he continued to look on his profession as a vocation and that his job was "fantastic".

But he added: "Many rural areas are great to live and to work in but being tied to the job 24 hours a day, seven days a week, is a major consideration for people and there are big areas of Scotland where there are recruitment crises."

Overstretched practices can opt out of some services such as immunisation
Some types of care will be shifted to nurses, paramedics and primary care trusts
New services, such as specialist care currently undertaken in hospitals, will shift to GP practices
Up to 30% pay increase for practice staff and parity of pay for all GPs in rural and urban areas
Dr Frances Elliot, the interim chief executive of Fife Primary Care NHS Trust which will be one of the trusts taking over some of the services, said that despite the overhaul to come, patients should not notice change.

She said: "I would like to reassure the public that they will get a GP out of hours but not necessarily their own GP out of hours. That is already the case in Fife because we have GP co-operatives who work in the out of hours period.

"Much work has to be done if we want to deliver the services in the future, but patients should not notice a difference."

Dr Elliot added that the future would offer "good quality service rapidly delivered" and based on "team working".

Dr Dickie, his four colleagues in Stornoway on the Isle of Lewis, and the rest of the UK's 36,000 GPs, will vote on the proposals in March.



Eleanor Bradford reports
"The contract is the biggest change since the 1960s"

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