Lives on the line as surgeries close

IT will certainly be a festive season to remember for hardworking family doctors and their staff. Surgeries across Scotland are to close for eight days during the Christmas and New Year period, leaving the NHS 24 telephone hotline to deal with patients who fall ill.

Health bosses insist that the cover will be adequate, and they claim it would have been “confusing” for patients if some surgeries had been open and others were shut.

But the move has prompted concern from patients’ groups, criticism from doctors’ leaders and a call for a rethink from former Edinburgh GP, now Lothians SNP MSP Ian McKee.

The situation arises because Christmas Day and Boxing Day and January 1 and 2 fall on Thursday and Friday, meaning two public holidays just before the weekend for two weeks running.

NHS 24 has suspended its normal rotas to make sure extra staff are available to cope with increased demand.

It expects a total of around 89,000 calls over the eight days when GP surgeries are closed, with about half of the calls coming between 8am and 1pm each day.

To cope with the demand, it says every seat in its four main regional centres and five local centres will be occupied, with up to 300 advisers available to answer calls. And all frontline staff will have to work six out of the eight key days.

But figures from Easter this year show that heavy demand – 39,497 calls over four days, compared with 33,109 during the same period last year – doubled the time it took to answer calls to NHS 24 from six seconds to 13.

Margaret Watt, chairwoman of the Scottish Patients Association, said it is “unacceptable” that surgeries will be closed for such long spells.

“Why do they have to close down?” she asked. “They are a public service, like buses or telephones. A couple of days should be sufficient. Why can’t they stagger it? If someone doesn’t get the time off on the day, they would get it later on. It should be possible to have a skeleton staff at every surgery.”

And she said that dialling NHS 24 for help is not a satisfactory substitute.

“A lot of patients are not comfortable with NHS 24. It’s not the same as speaking to someone face to face.

“Doctors are very astute. They can often tell by a person’s body language if there is something wrong.”

Dr McKee, who was a GP in Sighthill and Wester Hailes for 34 years before entering the Scottish Parliament, is also concerned about the four-day closure.

“It’s not really good medicine for people to be without their own doctor for four days at once,” he said. “We are giving a potentially lower standard of care.”

But he said it is a natural consequence of the new GP contracts introduced in 2004, which allowed family doctors to withdraw from providing out-of-hours care.

Before that, said Dr McKee, doctors had 24-hour responsibility for their patients, and over holidays like Christmas and New Year, they would agree arrangements to cover for one another.

“Local doctors ran a co-operative,” he said. “We had 13 practices in south-west Edinburgh looking after each other’s patients throughout the whole period.

“We took turns to work six-hour shifts or overnight shifts. It meant that, although there was a high probability you wouldn’t see your own doctor, you would see a doctor who knew the area and had access to your doctor.

“It was very different from ringing NHS 24, where your call might be answered in Aberdeen.

“If the only way you can get medical advice is ringing NHS 24 – while you are getting a good service as far as it goes – I don’t see how it can be as good as having local doctors looking after your needs.”

He said he is not blaming doctors for the situation.

But he added: “Everyone should get together and think of some way of stopping this happening.”

The Scottish Government’s official line is that the opening times for GP surgeries are simply down to public holidays falling just before weekends.

“We did not want to create inconsistency by altering this statutory arrangement, and there has been no approach to us about doing so.”

But the British Medical Association, which represents doctors, claims it’s also about hard cash.

Dalkeith GP Dean Marshall, chairman of the BMA’s Scottish GPs committee, said: “There are plenty of GPs willing to work in the Christmas period, but NHS 24 and NHS Scotland are trying to save money.”

A Government insider said: “This year the holidays happen to fall on Thursday and Friday, and therefore result in a four-day break over each weekend.

“But we are emphasising to people that NHS24 will be accessible around the clock, and it will have extra staff to cope with the anticipated rise in the number of calls. And that’s in addition to the fact there will be hospitals open 24 hours as well.

“Just because GPs won’t be accessible for two four-day periods doesn’t mean that health coverage stops.

“The plans in place are very robust, and we are confident the NHS in Scotland will be able to cope.”

NHS Scotland has already launched a high-profile advertising campaign advising people to ‘Be Ready for Winter’, which includes ensuring they have a repeat prescription for any medication they may need while surgeries are closed.