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Last Updated: Thursday, 1 April, 2004, 11:42 GMT 12:42 UK
New contracts for family doctors
GP at work
Family doctors will no longer have to turn out at night
Scotland's family doctors have begun working under a new contract system.

The new contracts have been designed both to improve out of hours care and relieve GPs of responsibility for evening and weekend cover.

The deal is expected to have a major impact on rural doctors, who will be able to change working practices and opt out of being on call at night.

The telephone service NHS 24 will handle all out of hours enquiries later this year.

Health boards will recruit doctors, nurses and other health staff to treat patients out of hours and GPs will have the option to do these shifts as overtime.

Dr David Wrigley, spokesman for health education charity Developing Patient Partnerships, said: "For the majority of people, the new GP contract will not result in dramatic or sudden changes to the health services provided in their local area.

"However, it is vital that health boards inform people about how to access local NHS out of hours services and reassure people of the continuing quality of care."

'Wide awake'

Callander doctor Kerry Mathewson believes the new contracts are a tonic.

"The reality is that even now it might not be me that attends patients out of hours," he said.

"In the future we will still be doing out of hours, we will still be part of the team that's covering patients - much the same as we were doing before."

But he added: "What it will ensure is that during the working day the rural practioners are actually wide awake and able to put more energy into actually treating patients."

Hopefully it will not affect patients who want to be seen urgently, but there is always that risk that you have less urgent appointments available
Dr Isabel Gibson
General practioner
However, his colleague Dr Isabel Gibson has reservations.

"I think the drawbacks are that it will be difficult sometimes for patients to get appointments when they always need them," she said.

"Things will be run along the lines much more of clinics, so it will probably be a more structured workload for ourselves."

Dr Gibson added: "Hopefully it will not affect patients who want to be seen urgently, but there is always the risk that you have less urgent appointments available."

The biggest GP shake-up in 40 years is aimed particularly at giving a fairer deal to doctors in rural areas, who may get less money because they have fewer patients.

Changes are intended to give them more control over their workload. They will receive recognition, too, for often having to replace the role of local hospitals.

Most GPs are self-employed and run their surgeries like a business, from which they claim a salary.

Doctors in Scotland have traditionally been an average 5,000 worse off because their list sizes are smaller.

But under the new arrangements they will be paid according to the type of their catchment area and for the range and quality of the services they provide.

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