Tha èiginn le suidheachadh nan dotairean teaghlaich, le Murray MacLeòid

Tha ceist a-nis dè bhios ma choinneimh a’ choimhearsnachd.

[English-language version below]

Chan eil sinn air cus a chluinntinn mu dheidhinn seo anns an ùine ud, ach tha e ann an cunnart èiginn nach beag a chruthachadh, agus chan eil sinn a’ bruidhinn dha na Barraich a-mhàin nas motha.

Tha an suidheachadh a’ cuairteachadh an Dr Mark Wilcox sònraichte, leis an eas-aonta a th’ air a bhith ann le Bòrd Slàinte nan Eilean Siar mun t-slighe air adhart.

An-uraidh, leig an Dr Scott McMinn – a bha còmhla ris ann an ionad meidigeach Bharraigh ann am Bagh a’ Chaisteil – dheth a dhreuchd cuideachd (bha e air an aois sin a ruighinn) agus tha sin a-nis a’ ciallachadh nach bi dotair teaghlaich làn ùine air fhàgail air an eilean.

Tha seirbheisean meidigeach taobh a-muigh nan uairean làitheil an urra ris a’ bhòrd-slàinte ach ann am Barraigh, tha iad air sin a chur ann an làmhan nan dotairean ionadail tro chùmhnant.

Ach, tha iadsan air a bhith togail dragh mun t-slighe air adhart agus chan eil càil a' choltais gu bheil am bòrd-slàinte air cus feairt a thoirt dhaibh.

Ged a tha dotairean teaghlaich ag obair air an ceann fhèin, tha uallach air a’ bhòrd deànamh cinnteach gun tig seirbheis choileanta a chumail. Thuirt neach-labhairt gum bi iadsan a-nis a’ gabhail smachd air an ionad mheidigeach gus am faighte air rudeigin a chur air dòigh san ùine fhada.

Tha Murray MacLeòid ag ràdh gu bheil margaidh an fhearainn a-mach à rian

Ach, ri linn mar a tha duilgheadas ann dotairean teaghlaich fhaighinn a dh’obraicheas anns na sgìrean dùthchail san fharsaingeachd, chan eil e idir soilleir am faigh iad air a dhàanamh – fiù ‘s le feadhainn a’ tighinn a dh’obair ann airson greis bheag mar locums – gun luaidh air dithis a bhios deònach an t-ionad a ghabhail a-nall gu tur.

Tha còrr air mìle duine a’ fuireach ann am Barraigh agus bidh na h-àireamhan a’ dol suas gu mòr as t-samhradh ri linn turasachd. Mar sin, chan eil obair a dhìth ann.

’S e fear dhe na duilgheadasan san fharsaingeachd, coltach ri gu leòr eile, ‘s nach eil daoine san là a tha ann ag iarraidh an t-uallach a bharrachd a ghabhail a bhios a’ tighinn ma choinneamh a bhith beò air an iomall.

Tha na dotairean ùra airson obrachadh anns na bailtean mòra, far a bheil na h-uairean obrach aca nas cinntiche agus far a bheil e nas fhasa tìde dheth a ghabhail.

Agus mar as motha a leanas sin mar a tha e, ‘s ann as duilighe a bhios e a chur ceart. Mar as motha an crìonadh a thig air àireamhan nan dotairean teaghlaich anns na sgìrean dùthchail, ‘s ann buileach as duilighe a bhios e feadhainn eile fhaighinn a thig nan àite.

Tha e soilleir carson a tha seo na dhuilgheadas, ach tha e draghail ann an seagh eile. ‘S e sin, mura eil dotair ri làimh san sgìre, chan eil sin idir tarraingeach dha teaghlaichean òga no dha daoine ùra a thàladh dhan àite.

Dh’fhalbh na làithean nuair a bhiodh an dotair teaglaich ri fhaighinn tron là is air an oidhiche agus chan eil duine a’ sùileachadh gun tig sin air ais.

Ach, chan eil e idir mì-reusanta a bhith an dùil ri seirbheis choileanta, as bith dè a' phàirt dhen dùthaich anns a bheil thu a' fuireach. Aig a’ cheann thall, chan eil ann an sin ach a' bhunait air an deach seirbheis slàinte na dùthcha-sa a stèidheachadh sa chiad àite.

English-language version:

The resignation of the only GP left in Barra has highlighted an issue which, given all the problems we are currently facing, has gone largely unremarked, but which has long threatened to evolve into a real crisis: the lack of GP cover in the more rural areas.

The circumstances surrounding Dr Mark Willcox handing in his resignation from the Barra Medical Centre in Castlebay may be particularly unique as it comes on the back of a long-standing dispute with the local health board, NHS Western Isles.

Last year, his partner, Dr Scott McMinn, retired, leaving him the sole full-time occupant of the practice.

Out-of-hours cover is currently sub-contracted to the local GPs on the island from the health board, but the doctors have expressed concern over future proposals to be put in place once the island’s hospital is refurbished.

While GPs are independent contractors not directly employed by the board, there is a responsibility on the board to ensure cover. A spokesperson said they would now take control of the practice until a permanent solution can be found.

However, due to the real recruitment problems that exist across rural areas for GPs, it is not at all clear that an adequate service can be maintained – even in the meantime with locums – far less what’s in store for the island and its residents in the long-term.

Barra has a resident population of over 1,000 which increases substantially in the summer months through tourism traffic. It is far from an area devoid of demand.

One of the main problems with recruitment generally, as with so much else, revolves around an increasing mindset towards urban living.

Newly qualified GPs want the security and consistency that comes with working in a city practice or hospital, where a nine to five workload (or least better defined hours) is more guaranteed along with more flexible time off, due to the presence of higher numbers of colleagues able to cover.

It is a vicious spiral. The more the number of GPs in rural areas reduces, the more difficult it then becomes to recruit willing replacements.

Not only does this create real problems in terms of the provision of primary care, but it also has an effect on depopulation, as it makes these communities less attractive for young families or new entrants.

Long gone are the days when the family doctor was available day and night, seven days a week, and no-one reasonably expects a return to those days.

But nor is it unreasonable to expect equitable cover no matter the location. Universality was the founding principle of the National Health Service and the emergence of a postcode lottery on GP cover, even by default, would carry profound implications.